CONTRACT # W912DQ-04-D-0017, T.O. DK03 

Environmental Chemical Corporation 

Omaha Lead Remediation, Omaha, NE US Army Corps 

of Engineers 

ECC Certification for Property Closeout 

BVID 32511 Property Address 3722 N 28 St 

Field Work Started 09/08/2006 Field Work Completed 09/15/2006 

Summary: 

• The excavation was performed in compliance with the work plans and specifications. 

• Fl excavation depth varied from 4 to 6 inches below ground surface. 

• F2 excavation depth varied from 4 to 6 inches below ground surface. 

• Drip Zone excavation depth varied from 12 to 13 inches below ground surface. 

• 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. 

• Sod placement and site restoration were conducted in compliance with the specifications and 

work plans. 

Comments: 

None. 

.iQ ECC Project Manager \\~M-PL 

Name ^ Title Date 

JeffHubbard USAGE Con Rep 

Name Title Date 

40286428

mill 

Superfund 
32511

 

Omaha Exterior Paint North Arrow Lead Site Owner Name: FRANK S MURPHY fj Good Site Sketch Address: 3722 N 28 ST fj Poor 

Phone:

 H: W: paint 

Sample Number Lead 

Concentration 

Sample 

Collected 

Samples Collected 

fA.TT 

RYASCPXA-32511 

RYBSCPXA-32511 

RYCSCPXA-32511 

RYDSCPXA-32511 

RDZSCPXA-3251 1 

Lab RYASCPLA-32511 

Result 498 ppm 

ENTERED 

Aim 

Omaha Lead Site 46130 
page 1 of. 

Omaha Lead Site 

Omaha, NE 

U.S. Environmental Protection Agency Region VII Residential Yard Soils

EnvironmentalRestoration 

Services 

PROPERTY ACCESS (to be completed by property owner) 

US. Environmental Protection Agency (EPA) has contracted the U.S. Army Corps of Engineers (USAGE), Omaha 

District to conduct environmental restoration services for the Omaha Lead Site. USAGE Omaha is working with 

Environmental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration 

services. Your cooperation is requested in giving EPAAJSACE/ECC permission to access your property during the 

removal/restoration phase. For further information please contact Don Bahnke, EPA Project Manager at (913) 551­

7003 or the Office of External Programs, at 1-800-223-0425. 

Property Access Granted By 

(Please Print Name) 

2 

;Property Owner Signature) | (Date) 

V 

NOTE: Granting permission DOE;>ESAK>F S /necessarily imply your property will be remediated at this time.

PROPERTY INFORMATION 

(to be completed by resident and/or properly owner • Please Print) 

Resident Name: [$/cCowne, r D renter 

J^\ 

ResidenceAddress: ;> 

(CITY) (STATE) 

Property Owned By:: C H ( 

Owners mailing address: s, 

Owner's telephone number - Home: CMCQ ^^ ) M J/ C/)") Op Work: Opcj - CK/?/ O 

Age of Home? | C/^ years How long have youlived here? / / years 

Has the exteior been painted or covered with siding since 1978? LlKYes No 

Has the interior been painted or covered since 1978? LJ Yes 

Total number of occupants: List Ages: 

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

omments: 

AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS 

The activities to be implemented by EPA under this agreement are pursuant to Section 104 of CERCLA, 42 U S.C. 9604. EPA's right of access to 

he property for in Section 104(e) of CERCLA, 42 U.S.C. 9604 (e), which provides entry for, "determining the need for response, or choosing or 

aking any response action under this title, or otherwise enforcing the provisions of this title." 

AccessAttempts: 

First: Second: Third: 
Contract No. W912DQ-04-D-0017, Task Order DK01

 

Omaha Lead Site, Omaha, NE 

Property Closeout Agreement 

BVID Property Address 33S-JI .?ojki N 2? sr 

Property Owner Is the Owner the Resident? B"Tes D No £LJS£ MVRPH1 

Compliance Statement: 

U.S. Environmental Protection Agency (EPA) has contracted the U.S. Army Corps of Engineers 

(USAGE), Omaha District to conduct environmental restoration services for the Omaha Lead Site. 

USAGE Omaha is working with Environmental Chemical Corporation (ECC) to remove lead 

contaminated soil and provide subsequent restoration services. 

Your cooperation in giving EPA/USACE/ECC 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 (913) 551-7003 or the Office of External Programs at 1-800-223-0425. 

Additional Comments by USAGE and/or ECC: 

CONTRACTOR CERTIFICATION 

Prashant Khanna or ECC Project Manager 

Charles "Skip"Milton 

Name Title. Date Signature \ t 5k;/) M;UuA (W to-ZS'0(f l\v v. XA 

PROPERTY OWNER SECTION 

This agreement documents the completion of remedial/restoration efforts at the property to my 

satisfaction. 

ii=rlagre e that restoration is completed at my property, except as noted 

Comments (if applicable): 

r> 

Property Owner's Signatu Date 
Property Owner Satisfaction Survey Form 

Omaha Lead Superfimd Site 

Performance-Based Contracting (PBC) Pilot Project 

Remediation Contractor: 

Property Identifier Number: 

Property BV1D Number: 

Property Address: J^A // ^f -S7" 

Property Owner's Name: £LlSf 

(above information to be filled out by remediation contractor prior to delivery of form 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 (USAGE) 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 return it to USAGE in the attached self-addressed & stamped envelope. (Additional 

comments may also be provided in the space provided, at the option of the property owner.) 

9-10 "excellent" 

7-8 "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 

8 3 

7 2 

6 1 

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

Property Owner's Signature: L>OoQ_D J\\ UJJY") Vwv Date: 
CONTRACT # W912DQ-04-D-0017, T.O. DK03

 

.n. Environmental Chemical Corporation 

Omaha Lead Remediation, Omaha, NE US Army Corps 

of Engineers 

Analytical Results Summary 

BVID #32511 

3722 N 28 St 

Sample 

Type 

DE 

DE 

DE 

PX 

Quadrant 

DZ 

F1 

F2 

EA-E 

Depth 

13 

12 

6 

0 

Date Collected 

9/8/2006 

9/8/2006 

9/8/2006 

9/8/2006 

XRF Results 

(ppm) (avg.) 

175 

59 

244 

56 

Lab Results 

ppm (avg.) 

N/A 

N/A 

N/A 

N/A 

BVIDBV1D is a particular residential property ID from which the sample is collected. 

The sample type identifier (with sequential sample number for that location) as follows; 

PX = Pre-Excavaiion XRF sample 

PE = Pre-Excavation laboratory sample 

DE = During and Post Excavation 

Quadrant describes the sampling location (with sequential sample number for that location) as follows; 

FI or F2 = Front Yard One or Front Yard Two 

BI or B2 = Back Yard One or Back Yard Two 

DZ = Drip Zone 

GA = Garden 

PA = Play Area 

EA = Easement 

Depth describes the depth from which the sample was collected. 

- ppm = parts per million 
pg-_ot_

 

List of Existing Conditions 

Property Address: /U £<F^ J^ DVD ID # 

Owner: Date: BVID# 

Ref: 

Photo 

# 

Description 

Owner Signature ECC 

Print & Sign Print & Sign P 
Property Check Lists QC 

Location ,?•}•?? AJ. ?&> 

BVID 3tti 

Dates <& £ 6^ M-J^O- f-7<5V£ 

Excavation check list 

have easement map 

have site map 

home owner agreement 

line locator 

access log 

decon. station 

tape barricade 

garden hose 

reconstruction map for buildback 

fences 

sod areas 

mulch 

gravel 

notes 

name and date 

C 

QC Notes 

XRF check list 

have easemet map (1) 

have site map (3) 

easements sample 

F1 samples 

F2 samples 

B1 samples 

B2 samples 

DZ samples 

AS-Built 

map corrected 

shots mapped 

concrete mapped 

trees marked 

LIP marked/noted 

name 

date 

easement mapped 

window wells mapped 

ac mapped 

Log book up to date 

Jk* 

Backfill check list 

reconstruction map _L 

positive drainage from house 

NO low spots 

NO Rake Gaps 

lawn even 

soil compacted 

sidewalk 1" cuts 

smooth transition from walks 

area free of debris 

fences repaired 

damage to property? 

damage list 

punchlist filed 
32511

 

Omaha QExterior Paint North Arrow Lead Site Owner Name: FRANK S MURPHY 

Sit n Good e Sketch Address: 3722 N 28 ST Poor 

Phone: H. W: paint 

Sample Number 

RYASCPXA-32511 F1 

Lead 

Concentration 

D0m 

Sample 

Collected LAB 

0-1 Firm: 

Date: ^ 

Samples Collected 

fATT 

RYBSCPXA-32511 F2 Time: I [ • 

RYCSCPXA-32511

RYDSCPXA-32511

 B1 

 B2 

ppm B^" D 

n Samples Analyzed 

RDZSCPXA-32511 DZ ppm n XRF Unit: 

Lab RYASCPLA-32511 ppm e a Date: _ O 

Result 498 ppm ppm Time: 

Number of Samples = ^-j Staff: 

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Omahc aint North Arrow i Lead Site Exterior P 

r Owner Name: FRANK S MURPHY [~] Gooc i Site Sketch Address: 3722 N 28 ST f_] Poor

 

Phone: H: W: [T^Jotptaint 

Sample Lead Sample Samples Collected Number R

 

Concentration Collected *~ Firm: r£ . fA~T fY\uS.\>J f *j ^J ^^ 

RYASCPXA-3251 1 F1 & / ~^ pom n [Pf Date: ^' 1 3- '^

 

RYBSCPXA-3251 1 F2 /£> 7 --S ppm Time: 1 1 -' \.O f^^ 

RYCSCPXA-3251 1 B1 >J^- "5^ pm s^ n Samples Analyzed RYDSCPXA-3251 1 B2 J<i-7 Ppm DtK^--. fj 

RDZSCPXA-32511 DZ 7&1 Ppm ¥f D XR F Unit: &i "Z" Book: &/ 

ppm Lab RYASCPLA-3251 1 LJ Date: -^~ ^/-^^ 

ppm V 

Result 498 ppm 1 | T me: /&~/^7 

I Staff: xd^7

^*?7 

Number of Samples = 

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