TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: ^a^6 l 

Date: ^p4^|CPl 

Address: \?,V^ S> ^ 6 S T 

Remediation Contractor: Coastal Environmental Group_ Year: 2008 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) 40315490 

Executive Summai^ 

Superfund 

EPA-provided property sketch 

Signed Access Agreement for subject property 

m 

Signed Access Agreement(s) for adjacent property 

Restoration Agreement 

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

Confirmation data 

Photographs p^e^-^^fLflJQi^oyv^ je.)C.c/h\aIim^ (to/U^od 

As-built sketch 

Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 

Description of areas not meeting ROD cleanup criteria 

Utility clearances 

Property information from Douglas County Assessor's Office 

D 

^%a.^ 

AHate 

^//(^/ol 
m % 

Property Access Checklist 

Propertj ID: Z Q 3 ^ 1 n WORK STARTED ON: / / 

Property Address: ) ^ "7 $ 7 f^ "^ J " D WORK COMPELTED ON: / / 

Owner: Y^-^^] \(f^rir r Renter: 

Phone: 

Fa.\: 

Cell/Pager: 

Phone: 70" ; _ )7t,l- | Additional Information: 

Fax: 

Cell/Pager. 

Address: S^m^ ^ 

D Notification Letter Sent: / / By: 

^ Access Agreement Siened: |0 / )'K 1 0^ By: u 

Q Restoration Agreement Signed: Jli/il/ ^ By: 

Ld 

\Z\ Topsoil Sampling (if applicable) / / By: 

d Disposal Sampling (if applicable) / / By: 

CU Garden Sampling (if applicable) / / By: 

\ ^ Utility Clearance Called: ill/A/fl S By: 

]Oinio^ 

7] Video/Photos (Before) On:42_/jLb/JiS By: N,chu\a^ 

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

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

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

d Property Completion Agreement Signed: / / By: 

n Final Report Issued: / / By: 

Air Monitoring (as applicable ) 

n Communit}- O Crew On: / / By: 

Results: 

• Community' D Crew On: / / By: 

Results: 

1 1 Community' Q Crew On: / / By: 

Results: 

Omaha Lead Site 

1 
# 

CONTACT FORM 

Property ID # 7.035 1 

Property 

Address: )1.1~7 S 1 ^ S T — 

Initial Contact: Date: Time: Action: 

Second Contact: Dale: Time: Action: 

Final Contact: Date: Time: Action: 

Final Action: Transmit to EPA D Other Action; D 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

i 
Douglas County Account Information Page 1 of3 rormat 

Dougla s County , Nebrask a Propert y Recor d - R22194800G 0 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 90th St - Vij W O n Ma £ Information is valid as of 2008-9-4 Treasurer's Tax Report 

New Feature -•->- > Auto Sales Search 

Owne r 

KEENER PAUL C 

ETAL 

1317 S 25 ST 

OMAHA NE 68105-0000 

Propert y Informatio n 

Key Number: 1948 0000 22 

Account Type: Residential 

Parcel Number: 2219480000 

Parcel Address: 1317 S 25 ST 

OMAHA NE 68105-0000 

Legal Description: SHULLS 2ND ADD LOT 18 BLOCK 12 50 X 126 

Valu e Informatio n 

Land Improvement Total 

2008 

2007 

2006 

2005 

2004 

2003 

$4,900.00 

$4,900.00 

$4,900.00 

$4,900.00 

$4,900.00 

$4,900.00 

$80,400.00 

$80,400.00 

$79,000.00 

$79,000.00 

$79,000.00 

$79,000.00 

$85,300.00 

$85,300.00 

$83,900.00 

$83,900.00 

$83,900.00

$83,900.00 

' 

Sales Informatio n 

Sales Date: 2003-07-25 

Deed Type: WD Book: 2003 Page: 161249 

Price: $51,334.00 

Grantor: Galen R Myers ETAL 

Grantee: Paul C Keener ETAL 

Valid/Invalid: Valid 

Exclusion Reason: 

Sales Date: 1996-06-06 

Deed Type: D Book: 2039 Page: 550 

Price: $65,000.00 

Grantor: 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accoimtno=R22... 9/27/2008 
Douglas County Account Information Page 2 of 3 :or|^ti 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Sales Date: 1993-06-14 

Deed Type: Book: 1953 Page: 397 

Price: $46,950.00 

Grantor: 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.14 6300.0 1.0 126.0 50.0 No 

Improvemen t Informatio n 

Building 1 

If ) '.r*liiiVJ»l 

(44 d -i ^ a 

M O 

ti p 

liCr 

%« 

FIn l rVOCf 

874 0 sq 1 

1 

Swsnd Floor 

•n^Qt q ft 

u t 

•$0 

^ 

tfO 

2 STORY tW-K tlxk!.' « 

Fin Bsmt nti irKl in bu l L v 

CLICK TO ENLARGE IMAGE 

Square Footage: 

Perimeter 

Unit Type: 

Built As: 

HVAC: 

Exterior: 

Interior: 

Roof Cover: 

Roof Type: 

Fioorcover: 

1706.0 

0.0 

2 Story 

Central Air to Air 

Frame Vinyl 

Plaster 

Composition Shingle 

Gable 

Allov(/ance 

Percent Complete: 

Quality: 

Condition: 

Condo Square Footage: 

Rooms: 

Units: 

Baths: 

Bedrooms: 

Stories: 

Foundation: 

100.0% 

Average 

Good 

0.0 

7.0 

1.0 

3.0 

3.0 

2.0 

Block 

http://douglasne.mapping-online.com/DouglasCoNe/static/accounfinfo.jsp?accountno=R22... 9/27/2008 
Douglas County Account Infonnation Page 3 of 3 onjmti 

Sprinkler Square Footage: 0.0 

Year Built 

1910 

Detail Type 

Add On 

Appliance 

Basement 

Basement 

Fixture 

Fixture 

Fixture 

Garage 

Porch 

Porch 

Porch 

Year 

Remodeled 

0 

Percent 

Remodeled 

0% 

Detail Description 

Fence Chain Link 

Allowance 

Bsmnt Block 8 ft 

Minimal Finish 

Additional Fixtures 

Base Fixtures 

Bath Full 

Detached 

End Solid Wall 

End Solid Wall 

Slab w/Steps 

Adjusted Year 

Built Physical Age 

1910 98 

Unrts 

1.0 

1.0 

864.0 

550.0 

2.0 

1.0 

3.0 

240.0 

192.0 

144.0 

20.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R22... 9/27/2008 
Page 1 of2 

Create Another Ticket Back to Irth Internet Send Email 

• YOUR TICKET NUMBER IS 2157637. 

Original Call Date: 10/18/08

Work to Begin Date: 10/22/08

 Time:

 Time:

 7:20 pm

 7:15 am 

 Op: ELIZABETH18790 

State: NE 

Address: 1317 

County: DOUGLAS 

Street: S 25TH ST 

Place: OMAHA 

Twp: 15N

Twp:

 Rng: 13E

 Rng:

 Sect-Qtr: 28-NE 

 Sect-Qtr: 

Legal Given: C 


Type of Work: lead remidiation 


Location of Work: LOCATE ENTIRE PROPERTY STARTING INCLUDING THE HOUSE AND 


: ALL THE WAY TO THE STREET. 


Remarks: FAX ALL CLEARS TO: (877)662-4211 


Company : COASTAL ENVIRONMENTAL SERVICE 


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


Work Being Done For: coastal 


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


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV LEVELS MCLEODNE MUD02 OMAHACOF 0PPDGPR6 QLNNEIF 


QWEST2 


Service Area Contact Phone Number Utility 

Type 

CXCATV COX COMMUNICATIONS, 

INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

LEVEL3 LEVEL3 COMMUNICATIONS, 

LLC NA 

Day: 8773668344 

Alt: 

Emerg: 8773668344 

MCLEODNE MCLEODUSA NO NEED TO CALL OUT 

EMERGENCY 

Day: 8002891901 

Alt: 

Emerg: 8002891901 

MUD02 METROPOLITAN UTILITIES 

DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047946 

http://www.dhon.org/irthinteraet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 10/18/2008 
Page 2 of2 

CITY OF OMAHA- OMAHACOF RON TRAFFICSEWER 

OMAHA PUBLIC POWER OPPDGPR6 NA DISTRICT 

QLNNEIF QWEST LOCAL NETWORK NA 

QWEST2 QWEST LONG DISTANCE SARA 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

Alt: 8887289343 

Emerg: 4067289343 

Day: 4067289343 

Alt: 

Emerg: 8887289343 

Day: 8002834237 

Alt: 3039921926 

Emerg: 8002834237 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 10/18/2008 
As-Built Drawing 

COASTA L Omaha Lead Superfund Site 

Name: k&r- c i-&iA.,« irj.j-s Omaha Lead Site Date: ^/p^ ^ North Anew 

Address; -.V^ 5^ 5 jr Stte Sketch Time: 

Phone: ruo3) ?^P-:i??v.4 

Dite 

Omaha Lead Site 46130 

Legend 

Concrete Drip Zone Excavated Quadrants Excavate d 

Area replaced

Sod 

 with Area replaced with 

Rock/Mulch Are a lef t bar e 

Contrac t #: EP-R7-07-05 Coastal Environmental Group Inc . 
4 

X 

Name: K^^r-^'-<?<i,2/i.i< ^'^i-^o 

Address: M O 5^5 3^ 

Phone; fL/o:i) 3 vp - a;^ v<^ 

a 

Team ler>^i /c/LAsb/y^'-j 

Sample Number 

^PXA - :ac>Tr/ 

^ 

.Sv 

sop: 

^ . j 

s 

^ 

^ 

^ 

2??ii2.i. 

o 

Omaha Lead Stte Date: 7/6^/ ^ North Arrow 

Stte Sketch Time: 

BVID# 7)0^5 1 XRF Code IIOL4. 

Lead Concentration Confirmation Sample 

/^/ Yes ° No 

A 2-Yes n No t n i 7 i fo PP'" /^/Ye s a No Q? ^ll'l g PP'­ /2Ye s n No ra­ ppm 

ppm >«?2.Yes tu No E

ppm /^Yes • No 

Yes • No 

( 

.^/ / 

^ 

ppm 

n—^ B . I. »^ x^¥-—-r- 1 — ^fc^--*^ ^ ' ".^ ' 'A \ ^ 

.\— :i£ 

-/4 

30 \ ' |2^iS o 

i / ! i i—-^ 

%±^yjdSL:U^Lia. .^ r r ' f.'-^-^ii 

: -rt • 

,) \ La.. i l 

^ 

^K 

^^^/ . 

Omaha Lead Site 46130 

^o^«-1vv-e H 
# 

^ 

^ 

Name: H&r-'c^(„z^.i .i.^,.^^ Omaha Lead Stte Date: 7/pV ^ North Arrow 

Address: .'1'7 5 as 3? Stte Sketch Time: 

Phone: ruoi) 3 vp - ;;i;^ v<<, 

Team icih", /c^Axb/yf^'-j BVID# 3/0^6 / XRF Code llf^U -

Sample Number Lead Concentration Confirmation Sample 

JAVA'S CPk/A - -z-fcTS/ ppm /=/ Yes ° No /^Vg>cPx/ A - -aoTg/" 

ppm pi-Ye s n No g- f2.V^^CPX A « ^oTr ; ppm /^/Ye s • No 5? 

ppm /ZYe s a No 03­

ppm /5?2.Yes [^ No CB 

ppm /'Yes a No 

ppm Yes • No 

- 5 

^ 

o 

•K 

Omaha Lead Site 46130 

,g,c».5 
Name: K^r-- '^•?'67x;<'<->f>-''^ 

Address: M*'? 5 3-5 ^T 

Phone: fuoy) 3vp-a?<v6 

Omaha Lead Stte 

Stte Sketch 

Date:

Time: 

 'T^^/fe North Arrow 

Team ici^ i /c/JAsb/yh.'-j BVID# 3<O;L^-/ XRF Code ^76 ^ 

Sample Number Lead Concentration Confirmation Sample 

ppm / = / Yes •=> No RVg>CPx/ A - -aOTg" 

ppm >r2_Yes n No g­ 1ZV^^<^PXA - -ZOlSl xtk ? t 30 ~ ppm / J/ Yes CD No l » I^YDSCPX/ ^ - 263Sf 

ppm /2Ye s O No 03­

ppm ^Z.Yes 1^ No £ ^ ^•2.'Z2:37 

ppm /Ye s n No g 

ppm Yes • No 

^ / / ff^ 

S 

)C •f—-jf^ 7t X. \~.^Lc^ r -;k- ^ 

frf iX 

^ Xx •••)^ : 

•k­ ; • t 

vdf 

zm^-3o |2^i?o 

~\— 

) i. 

"^la..4. 

4:z/^.!£li±:j > 

__^.^ .

ml i ^^2 ^ ^ ? 

^ 

r 

> PS 4?^-tsgl ^y>j^.^' 

?^ f ^ 

2??|i2i r 

I T Hj<-d *^ 

T .£1 

i^.-:^-i... 

,/Lm 

M . - ^ • ^ 

_5"/ ^ 

2j/o±'x4­

^/r-^^/. Omaha Lead Site 

46130 
# % 

COASTA L ENVIRONKENT& L 

G n O U r 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 

follov^ing described premises: 

Owner's Name: Daytime Phone: t^O^-" lOl ^ n(> H P«ui i eeise^r 

Address of Property 

covered by this 7/7 ^-^r. r 

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 fhe 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 
# 

% 

^ < # 

COASTA L ENVIRONMENTA L 

C « O U F , IN C 

• 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 work. 

• 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 

Environmental Group, at (712) 352-0188 

¥ 

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

Signature Signature Date 

O

 1 would like to be present during any sanrtpling that is required. 
# m

COASTA L • r ' (KOWMtNTA l 

C R O U ^ . IM C 

Restoration Agreement 

The purpose of this agreement is to provide a mutual agreement as to conditions ofthe property prior to 

remediation activities. Tliis will also serve as documentation for the purpose of assuring that restoration 

activities are completed to the satisfaction ofthe property owner and the United States Environmental 

Protection Agency (EPA). 

Property ID: ^(y j § / 

Property Address: / / / 7 ^ <:^ C 

Owner: 

Phone: lyo;x- HJ^-P-i^O 

On the attached diagram(s) indicate area(s) to excavated and depth of excavation, location of all known 

utilities, subsurface features, syrface structures and landscaping features, access iocation(s) to be used by 

contractor, and the direction of North. Indicate distances, depths, material types, etc. Indicate digital photos 

by referencing the phofo-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: 

-f-^y ^ , / y h^^>^y Ul,') 

Item: 

Item: 

Item: / 

/

Item: 

Item: 

Item: 

Item: 

Page 1 of. c 
# 

C p A S T A U fr«viHONr*VMTA L 

c n o u r . IN C 

Items To Be Removed By Contractor During Remediation And Not Replaced 

(Use additional sheets as necessary) 

Item: 

/V/?o^ ^1 QIcxn'h ' (^ f^ T h<z.l/^'/^^ ^ 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: / 

Item: 

Item: 

ttem: 

Item: 

Item: 

Item: 

Item: 

Page 2 of h 
# 

COASTA L rNVlMONMCNTA L C R o u r . IN C 

Items To Be Removed By Contractor During Remediation And Replaced 

(Use additional sheets as necessary) 

Item: . 

F7^ n ^ pa 

Item: 

ei 

Item: 

Item: 

Item: 

ttem: 

Item: 

Item: 

Item: 

Item: 

ttem: 

Page 3 of. c
I

# 

C O A 5 T A L 

 N*»i(»'oHntNr*t C R O U r . IM C 

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 

piL 

r' y 

/ 

j ^ 

y 

Unit 

Square feet 

Condition/Type/Species 

Each 

•. 

Each 

Each 

Each 

Square Feet 

Page 4 of 0 
C O A S>T A L rNviiioNr*ftNT* > c H o u r- . IM C 

Item Quantity Unit Condition/Type/Species 

Agreed upon value of 

Diant materials not to be 

replaced 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 conn-actor. 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 

area (s) 

Easement Area, to be 

excavated 

0 $ 

r Each 

f^ \ 

SF i

b 

r SF 

-i^" " SF 

Page ^ 5 of. 
# 

C O A S T A t. HMVAKOIAHKktTAL • C fi O W r'< t'M C 

Additional Coihrnents / Instnictions: 

^,^. i ,^ 0^y\, 

^^ >7 /^'^z c«^ re^ ^ 

yH ^VcV -(x>/ 

nx/^ 

D Check the box if Owner does not want CEG to dbctiment interior foundation walls and possilile 

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

interior of house, including foundation cracks; or fissures. 

( ^ I agree Q I do not agree 

Owoer's Signature Coofractor's Signature ^t e 

Page 6 of. 
BVID#^D2^A 

XRF PROPERTY SAMPLE SHEET 

Date \\-.^-OP> Address \^\n % ^ ^ ^V. Project Omaha lead FP 2nc) year opllon Sample time am/pm 

XRFID# .^ o f^H sample length 30 sec 

Shot# Reading Sample area Shot# Reading Sample area 

^•^1\ D DU.ift t \8.5^1 a^T^ rQD-Ti. .MSiSu^S 

=03- 1 V 3ui<.. <^'2.i ti-3 .a> P% c5^^-7 (^ '5o3-<not,Q(. n'^; 

^t 

Q.?,n Q =?bS.\ftt;3b,n3 Depth <^1- 7 5^13-111 -QB.a Depth 

c2)3l, ^ c5'^itv,o-^i.3^.:^5 U) .<;;^7 « /lAa Tit3 & 'fc­ \S 

Average ,S)^ ^ /^^t . Q o .^^ \ Average '^iq &(.. ^ .^-r, c M 

Shot# Reading Sample area Shot# Reading Sample area 

OrSH^ ^ U„^.f>Ut K:,.T^ 

^JJSBV Kir:> S3:t not ; ^c>^' ^ 

^38 P 307 . C'C-'l n.uu . Depth Depth 

^5b 3 3-Aa.o<.^lK V\ 1 

Average .QbS.l i H \n.?,\ Average 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

RETEST AREAS 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

lab sample # Lab result Sample area XRF Avg. 

Signature, 

NO 6M ^ Ufti. Print 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2374 

Mode SOIL 

Time 2008-11-03 11:36 

Duration 122.24 

Sequence Final 

Flags 

AVERAGE » Avg of 2370-2373 

ADDRESS 1317 s 25 st 

QUAD/ZONE PZ 

INSPECTOR Ventry 

DEPTH • 6 

SAMPLE TYPE , CLEARANCE 

NOTE 

Supervised By: 
# 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2370 

Mode SOIL 

Time 2008-11-03 11:33 

Duration 30.85 

Sequence Final 

Flags 

BVID # 20351 

ADDRESS 1317 s 25 st 

QUAD/ZONE PZ 

INSPECTOR Ventry 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 211.183 ± 18.398 

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 TYPE 

NOTE 

ppm 

Pb 365.989 

Supervised By: 

Certificate of Verification 

2371 

SOIL 

2008-11-03 11:34 

30.56 

Final 

20351 

1317 s 25 st 

PZ 

Ventry 

6 

CLEARANCE 

± Error 

± 23.319 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2372 

Mode SOIL 

Time 2008-11-03 11:35 

Duration 30.23 

Sequence Final 

Flags 

BVID # 20351 

ADDRESS 1317 s 25 St 

QUAD/ZONE PZ 

INSPECTOR Ventry 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 305.184 ± 20.839 

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 TYPE 

NOTE 

ppm 

Pb 299.047 

Supervised By: 

Certificate of Verification 

2373 

SOIL 

2008-11-03 11:36 

30.60 

Final 

20351 

1317 s 25 st 

PZ 

Ventry 

6 

CLEARANCE 

± Error 

± 21.238 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2379 

Mode SOIL 

Time 2008-11-03 11:40 

Duration 122.58 

Sequence Final 

Flags 

AVERAGE Avg of 2375-2378 

ADDRESS 1317 s 25 st 

QUAD/ZONE DZ 

INSPECTOR Ventry 

DEPTH 13 

SAMPLE TYPE CLEARANCE , 

NOTE 

Pb 919.060/ / ± 

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 TYPE 

NOTE 

ppm 

Pb 2076.429 

Supervised By: 

Certificate of Verification 

2375 

SOIL 

2008-11-03 11:37 

30.66 

Final 

20351 

1317 s 25 st 

DZ 

Ventry 

13 

CLEARANCE 

± Error 

± 56.936 
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 502.902 

Supervised By: 

Certificate of Verification 

2376 

SOIL 

2008-11-03 11:38 

30.96 

Final 

20351 

1317 s 25 st 

DZ 

Ventry 

13 

CLEARANCE 

± Error 

± 26.954 
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 542.116 

Supervised By: 

Certificate of Verification 

2377 

SOIL 

2008-11-03 11:39 

30.67 

Final 

20351 

1317 s 25 st 

DZ 

Ventry 

13 

CLEARANCE 

± Error 

± 28.116 
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 554.791 

Supervised By: 

Certificate of Verification 

2378 

SOIL 

2008-11-03 11:40 

30.29 

Final 

20351 

1317 s 25 st 

DZ 

Ventry 

13 

CLEARANCE 

± Error 

± 28.184 
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 

Supervised By: 

Certificate of Verification 

2384 

SOIL 

2008-11-03 11:43 

121.68 

Final 

Avg of 2380-2383 

1317 s 25 st 

easement 

Ventry 

1 

CLEARANCE . 
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 165.863 

Supervised By: 

Certificate of Verification 

2380 

SOIL 

2008-11-03 11:41 

30.53 

Final 

20351 

1317 s 25 st 

easement 

Ventry 

1 

CLEARANCE 

± Error 

15.798 
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 195.536 

Supervised By: 

Certificate of Verification 

2381 

SOIL 

2008-11-03 11:42 

30.66 

Final 

20351 

1317 s 25 st 

easement 

Ventry 

1 

CLEARANCE 

± Error 

± 17.207 
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 207.000 

Supervised By: 

Certificate of Verification 

2382 

SOIL 

2008-11-03 11:43 

30.24 

Final 

20351 

1317 s 25 st 

easement 

Ventry 

1 

CLEARANCE 

± Error 

± 17.449 
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 244.050 

Supervised By: 

Certificate of Verification 

2383 

SOIL 

2008-11-03 11:43 

30.25 

Final 

20351 

1317 s 25 st 

easement 

Ventry 

1 

CLEARANCE 

± Error 

± 18.791 
m Omaha Lead Site—Fixed Price EP-R7-07-05 

Coastal Environmental Group Inc. 

%. • J? www.coastalhazmat.com 

VPHO^^ ^ COASTA L ENVIRONMENTA L 

CROUP , INC . 

EXECUTIVE SUMMARY: 

BVID # 20351 - (1317 S 25 ST) 

I I No Issues or Concerns ^ Issues/Concerns 

Detail Explanation: 

HOMEOWNER REQUESTED MULCH INSTEAD OF SOD. 
- -

t .^EPA 

EPA Propert> Close Out Form 

Property tt: 'iPOJ^t: ^ Property Addreu: \'^\ 1 S - Q ^ ^V -

Datc/Tlmc: Owner's Name: ?Q-W^JL -

Quads Excavated: \;^?: ,_? ^ Conlractor Croup 0JOOL5<V<- ^ t:^^ t .roc^.*-^-^'^'^''-^ 

Excavation General Ves No 

1 If necessary, were the correct quadrant(5) excavated and restored? ^ 

2 If necessary, were the correct areas of drip zone excavated and restored'' 

^ 

CradloK Sod and VeccUtioD Yes No 

1 Does the grading around the perimeter ofthe house in excavated areas generally slope away 

from the house? t ^ 

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

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

^ daytime period) 

4 Are sodded areas generally fuTTi and evenly graded? ^ 

5 Are the joints t)etween the sod strips generally light? (Only evaluate if inspected at a 30 day 

time period) 

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

7 Was damage lo landscaping or plant materials avoided? ^ 

Gates, Fences and ReUinln£ Walls Ves ^o 

1 Do gates open and close freely? (If applicable) i ^ 

2 Were all gates or fences taken down during restoration activities reinstalled? (If applicable) 1 ^ 

3 Was damage to gates or fences avoided? (If applicable) ^ 

4 Was damage to retaining walls avoided? (If applicable) ^ 

Foundation, SidioK and Cullers Yes No 

1. Was damage to the siding or trim avoided? u ^ 

2 Was damage to the foundation avoided? < ^ 

3 Was damage to windows avoided? i ^ 

4 Was damage to windows or door screens avoided'' ^ 

5 Was damage to downspouts or downspout extensions avoided? ^ 

Sidewalks and Driveways (Concrele) Yes No 

Was damage lo driveway surfaces avoided"^ 

2. Was damage to walkway surfaces avoided? 
O mens comments; # t

Inspection notes: 

/\jo sa d pe r ? ^ R^ut^ - /TUM-IM^ 

Removal and restoration activates complete including the 30-day sod warranty 

EPA Represenlative :^^£^^^<J^^^^^.kJL^t' Date: //%;^f 
% 

'life 

Property Completion Agreement 

This agreement documenls the completion of remedial activiiies performed on my property. My signature 

will designate Ihat 1 am salLsfied with ijie restoration of my property, and that no items are in qucslion.s, 

now, or at any time in the future, except those items listed below, if any. 

PropcityjD: ^^^5- / _ 

Property Address: ^ 3 , ':^ " ^ Qj^__3t , 

Owner: fcu^ / ^^^^ ^ 

Phone: ^07--y^4Y ^ 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

J 

"TT/L^ I agree rrjitoralion i.s coniptelcd, except as noted 

 I I ilo not agree reslorafiun iv i-nmpleted 

* - : 

Owner's .Si)>naliirr l)a( Confractor's- .Sijjnature Date ' 

I