•r 

TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

^ SAID#: Date: n 

Address: Cl>(. f ^ \ f^i 

Remediaiion Contractor: CoastalEnvironmental Group Year: _2010ARRA 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) 

i/ Executive Summary 

/ EPA-provided property sketch 

t/ Signed Access Agreement for subject property 

Signed Access Agreement(s) for adjacent property 

Restoration Agreemenl 

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

Confirmation data 

Photographs X U ^ ^KVUrwn ^ ^MVA^H^, ^ } f < ^ 

As-built sketch 

Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 

Description of areas nol meeting ROD cleanup criteria 

Utility clearances 

Property informalion from Douglas County Assessor's Office 

D 

(j 

30218948 

•i 

Superfund 
Property Access Checklist 

Property ID; "V^UoH 

n WORK STARTED ON: __/__/_ 

n WORK COIVIPELTED ON: __/___/_ 

Property Address: •^'VU «^ "vV 

O^vncr: 

Renter: L_g&\fK VftAA 

Address: 

Phone: 

FJLX: 

Cell/Pagen 

Phone: Additional Information: 

HD^ - *\^\^ O^^l. Fax: 1ll.^2( ^ 9006­ j Cell/Pager: 

D Notification Letter Sent: / / By: 

lyl Access Agreement Signed: 0«\

 /"i-?. / vo By= MH-V. 

53 Restoration Agreement Signed: o«\ /^-s 1 \ o 

By= K.^u>. 

Q Topsoil Sampling (if applicable) 1 1 By: 1 

Q Disposal Sampling (if applicable) 1 1 By: 

D Garden Sampling (if applicable) 1 1 By: 

t0l%~V>IV a Utility Clearance 

Called:QA. /a-v / ^,. »3-o.,/^o.A„ \ ^ Video/Photos (Before) On: pp\ l^-\ 1 \ a ^y-Mtcu . 

D Video/Pbotos (During) On: / / By: 1 

D Video/Photos (After) On: / / By: 1 

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

0 Property Completion Agreement Siened: / / By: 

n Final Report Lssued: / / By: 

Air Monitoring (as applicable) 

O Community • Crew 

Rcsults: 

CH Community \ 3 Crew On: Bv: 

Rcsults: 

Omaha Lead Site 
Douglas County Account I ij^jj^tion 

Page 1 of4 

Douglas County, Nebraska Property Record - R2101430000 

Print Report 

View Interactive GIS Mao Informatipn is valid as of 2010-8-30 Treasurer's Tax Report 

New Feature •^ -4 -> Subdivision Sales Search 

Owner 

LADD PETRA R 

C/0 DBA PL ENTERPRISES 

POBOX 1812 

COUNCIL BLUFFS IA 51502-1812 

Property Informatio n 

Key Number: 0143 0000 21 

Account Type: Multiple Res 

Parcel Number: 

2101430000 

Parcel Address: 536 S 31 AV 

OMAHA NE 68105-0000 

Legal Description: REDICKS -E S- ADD LOT 4 BLOCK 2 S 5 FT LT 3 & N 40 FT 45 X 130 

Value Informatio n 

Land Improvement Total 

2010 $12,000.00 $63,000.00 $75,000.00 

2009 $12,000.00 $63,000.00 $75,000.00 

2008 $12,000.00 $63,000.00 $75,000.00 

2007 $12,000.00 $63,000.00 $75,000.00 

2006 $12,000.00 $63,000.00 $75,000.00 

2005 $12,000.00 $63,000.00 $75,000.00 

Sales Informatio n 

Sales Date: 2000-07-12 

Deed Type: D SooIr: 2157 Page: 259 

Price: $73,000.00 

Grantor: 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Sales Date: 1997-07-07 

Deed Type: D Book: 2065 Page: 687 

Price: $65,000.00 

Grantor: 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R210... 9/1/2010 
Douglas County Account Ii]fl|M|tion Page 2 of4 

Grantee: 

Valid/invalid: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.13 5850.0 1.0 0.0 0.0 No 

Improvemen t Informatio n 

Building 1 

1 T ieo Iff 

trd E 1 5*c.:«»d^k»e 

i H 

B30 0 IS n 

4BUL^ B - c^^^l^^^^^^^^^^^^^^l 

^M lIMO w 1 ».(. *' [ :• 

6a »o 

»ff 

iutiurrr, < MbOM a **i 

^ W 1 

Twoitoty 

CLICK TO ENLARGE IMAGE 1 

CLICK TO ENLARGE IMAGE 

Square Footage: 1950.0 Percent Complete: 100.0% 

Perimeter 154.0 Quality: Average 

Unit Type: Condition: Average 

Built As: Apartment <= 3 Stories Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 10.0 

Exterior: Frame Aluminum Units: 6.0 

Interior: Drywall Baths: 6.0 

Roof Cover: Composition Shingle Bedrooms: 5.0 

Roof Type: Gable Stories: 2.0 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1920 0 1920 89 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 

1110.0 

Basement Finished 960.0 

Fixture Additional Fixtures 

1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R210... 9/1/2010 
Douglas Coimty Account Ii ijl^Mation Page 3 of4 

Fixture 

Fixture 

Garage 

Porch 

Porch 

Base Fixtures 

Bath Full 

Detached 

Encl Screen 

Encl Screen 

1.0 

5.0 

216.0 

25.0 

200.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R210... 9/1/2010 
Douglas County Accoimt In^Batio Ii|^B|tion 1^ ^ Pag ^ e 4 of 4

http://douglasne.mapping-online.coin/DouglasCoNe/static/accoimtinfo.jsp?accountno=R210... 9/1/2010 
Page 1 of2 

"> 

Create Another Ticket Back to Irth Intemet Send Emaii ] 

YOUR TICKET NUMBER IS 2612617. 

Original Call Date: 10/08/10 Time: 2:03 pm Op: ELIZABETH18790 


Work to Begin Date: 10/13/10 Time: 2:30 pm 


State: NE Co\inty: DOUGLAS Place: OMAHA 


Address: 536 Street: S 31ST AVE 


Twp: 15N Rng: 13E Sect-Qtr: 21-NW-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: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV LEVELS MUDOl OMAHACOF 0PPDGPR5 lEC QLNNEIC 

UtiUty 
 Service Area Contact Phone Number Type 


Day: 4029340469 


COX COMMUNICATIONS, CXCATV HEIDI Alt: 4029340469 INC 

Emerg: 4029329757 


Day: 8773668344 


Tc^n^T, LEVEL3 COMMUNICATIONS, .... Alt: 
 LiiViiLj rrr ' 

Emerg: 8773668344 


Day: 4025047823 


METROPOLITAN UTILITIES MUDOl SANDY Alt: DISTRICT 

Emerg: 4025047970 


Day: 4024447197 

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

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 10/8/2010 
Page 2 of2 

OMAHA PUBLIC POWER OPPDGPR5 ELM LOCATING DISTRICT 

NO NEED TO CALL OUT PAETEC PAETEC COMMUNICATIONS EMERGENCY 

QLNNEIC QWEST LOCAL NETWORK ELM LOCATING 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

Day: 8002891901 

Alt: 

Emerg: 8002891901 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

http://wvm.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 10/8/2010 
1^ As-Built Drawing 

COASTA L Omaha Lead Superfund Site 

OLS#: 22604 

Date Excavated: 10/12/2010 

Date USEPA Slqned Off: 12/9/2010 22604 Area Sodden: 1125 so ft 

Omaha Lead Site Exterior Paint North Arrow Owner Name: PETRA R LADD 

Site Sketch • Good Address: 536 S 31 AV • Poor Phone: H: W: Q^wit paint 

Sample Number Lead Sample Samples Collected LAB Concentration Collected Firm: P.^ mTt- (Y\.-SA^ 

RYASCPXA-22604 Fl ppm D Date: <?; LJ>-a 

RYBSCPXA-22604 F2 ppm D Time: %'?S' fi^c\ 

RYCSCPXA-22604 Bl ppm I? D Samples Analyzed RYDSCPXA-22604 82 ppm D 

RDZSCPXA-22604 DZ ppm r D XRF Unit: ^ ' ^Book:^ / 

RGZSCPXA 2260'! ppm 

ppm sOinaha Lead Si 46 BO 

Legend 


Concre'te Drip Zone Excavated Quadrants Excavated 

Area replaced with Area replaced with 

Area left bare 
 Scxi ' ' Rock/Mulch 


Contract #: EP-R7-07-05 Coastal Environmental Group Inc. 

22604 

r\r(fir v.\- ^sdr^ 

46130 
22604 

Owner Name: PETRA R LADD 

Address: 536 S 31 AV 

Phone: H: 

Sample Number 

RYASCPXA-22604 

RYBSCPXA-22604 

RYCSCPXA-22604 

RYDSCPXA-22604 

RDZSCPXA-22604 

RGZSCPXA 2260-1 

RPZSCPXA 226011 

Omaha Lead Site 

Site Sketch 

W: 

Lead LAB Concentration 

6>'7 ^ I 

/sy^zp 

BI -J . I 

Number of Samples = y ^ | 

Exterior Paint North Arrow 

• Good 

• Poor 

Q-'fiot paint 

Samples Collected 

Firm: ^ ^ mrT - V(\y>-\> 

Date: ^L^' ^ 

Time: ^•^PS ' Ac^ 

Samples Analyzed 

XRF Unit: 0 I ^Bookij^ ^ 

Date: g-J/-^^^ 

Time: ^/ ^ 

Staff: 

Omaha Lead Site 46130 
22604 

Owne Omaha Lead Site r Name: PETRA R LADD 

Site Sketch Address: 536 S 31 AV 

Phone: H: W: 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

RYASCPXA-22604 Fl '2r^*r ' ppm n 

RYBSCPXA-22604

RYCSCPXA-22604

RYDSCPXA-22604

 F2 

 B1 

 82 

^"7 ^ ppm w ppm 

ppm 

D 

D 

D 

RDZSCPXA-22604 DZ /^i^ ^ ppm D 

R02SCPXA aaeoi—GZ- ppm •e - •Q -

RPZSCPXA aaeoi—PZ- ppm -B­ -BNumber of Samples = j^_ ^ [ Q 

y. ^^^ \ 

ENTERED 

•Aim t b 'OA^yi 

(jAftAb-e^ \ 

{A-T.O 

iJ 

v^ 

<3 sS3U ^ 

j 

o 

..0. 

f 

\//A\Vk 

.s: 'j|M/ 

Exterior Paint NorthArrow 

• Good 

• Poor 

\2['ik>\ paint 

Samples Collected 

Firm: P.'E fATT^ fY\ ^ V 

Date: ^-L^" ^ 

Time: ^.'AT fi^e\ 

Samples Analyzed 

XRF Unit: ^ I ^Book:j^ ^ 

Date: ^-^Z-^V -

Time: ^ M 7 

Staff: /P2755V 

-"k. 

s^ 

^) 

> 

<^7^ 

Omaha Lead Site 46130 
^^.,tosr.,^ 

C OASTA » 

iN«l>ONH||(Ui 

c It o u r.: IMC 

Consent fcr 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 

following described premises: 

owner's Name ^ ^ ^ : [^^k A Daytime Phone ^ ^ : \~'OH'^Z ^ 

Address of Property 

covered by this S1>CL ^ -^Icxvt. 

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 soii. 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, v^ll 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 virill receive v\fl-itten 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 the 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 
A * * * 

COASTA L 

IMVINOhHIKTAl - I PBort^ SHO O ' IK C 

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

piles, dog houses, etc; 

e 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; 

i 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 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 (402) 991-1199 

5 1 ^ gra D I do not grant access to my properties I grant access to my properties 

'/ ^ fyiyp/o 

Date Signature Date 

Q I would like to be present during any sampline that is required. 

Page 2 of 2 
COA S T A L • HViaOMMHNTAL a m o V r , INC . 

Restoration Agreement 

The purpose of this agreement is to provide a muttial 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). 

PropertylD: ^XCcCH 

Property Address: CJ3 ^ S . "iV ocoe 

Owner: fa^^ L ^ 

Phone: QtS^ ~C>'<';t':i 

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 responsibiiity. 

Kem: 

J\n\ / p W\"Vs Vti jge. SO-vreA 

Item: 

ttem: 

ttem: 

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

ttem: 

Lv SnTo-M <p\aA-fs Ic/f h^:^ 

ttem: 

ttem: 

ttem: 

Page 1 of. 
COA S T A L • MVIKONMI N T A I. o II o u r . INC . 

Items to Be Removed By Contractor During Remediation and Replaced 

ttem: 

"T^ONX

ttem: 

5w-\

ttem: 

ttem: 

Item 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 

tnmk diameter 

Number of trees <= 2 inch 

tiiink 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 

 F^,'^l,t>e 

 F^.^|JD ^ 

Landscape Inventory 

Quantity 

£f 

0 

^ 

Unit 

Quadrants 

Each 

Each 

Condition/Type/Species 

Each 

Each 

Square Feet 

$ 

Each 

1 

Page 2 of. 
COA S T A L 

O II O U P . INC . 

Additional Comments / Instructions: 

The ctty of Omaha ordinances may prohibtt 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 c£»e, 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 wtthstanding 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 ctty of Omaha's Planning Department at (402) 444-5150. 

Q Piease check this box if you understand the informsrtion outlined above. 

«? .N«^ . yCheck the box if Owner does not want CEG to document interior foundation walls and possible 

^preWisting damage. By checking this box CEG is not responsible for any damage done to the 

interiorpffiouse, including foundation cracks or fissures. 

not agree 

L l . 

»igna Signature Date :e Contractor's Sii 

Page 3 of. 
BVID# Z.7^^0^ 

XRF PROPERTY SAMPLE SHEET 

Date 1 ' LO^ - ZJOH Address 53 6 3 3 ; At/ e 

Project Omaha Lead ARRA Sample time am/pm 

XRF ID# 3'=^ot.-L sample length 30 sec 

Shot# 

1 

L 

3 

Reading 

46 5^ IQ 

ib ^ t ZO 

ISO t 1^1 

Sample area 

6( 

Depth 

6 " 

Shot# Reading Sample area 

Depth 

Average }s'\ ^ n «/ Average 

Shot# 

G 

b 

^ 

Reading 

b4 i 14 

"^0 i (6 

85 t lb 

Sample area 

F l 

Depth 

b " 

Shot# Reading Sample area 

Depth 

Average 80 t IS / Average 

Shot# 

"^ 

10 

I 

Reading 

{0 \ t [b 

lib t i ^ 

B'l i 15 

Sample area 

V i 

Depth 

/3" 

Shot# Reading Sample area 

Depth 

Average JOL 16 / Average 

RETEST AREAS 

Shot# Reading Sample area Shot# Reading Sample area 

y ^ / / Depth Depth 

Average Average 

Signature_ 

Print_iMlt^^jMM 
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 

4 

SOIL 

2011-01-20 13:43 

90.59 

Final 

Avg of 1-3 

536 S 31 AVE 

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 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 146.175 

Supervised By: 

Certificate of Verification 

1 

SOIL 

2011-01-20 13:40 

30.20 

Final 

22604 

536 S 31 AVE 

Bl 

6" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 18.673 
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 167.035 

Supervised By: 

Certificate of Verification 

2 

SOIL 

2011-01-20 13:41 

30.23 

Final 

22604 

536 S 31 AVE 

Bl 

6" 

C.PADILLA 

CONFIRMATION 

CLEAR 

Error 

± 20.188 
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 150.536 

Supervised By: 

Certificate of Verification 

3 

SOIL 

2011-01-20 13:43 

30.16 

Final 

22604 

536 S 31 AVE 

Bl 

6" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 19.633 
Thermo 

S C I E N T I F I 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 

8 

SOIL 

2011-01-20 13:45 

90.29 

Final 

Avg of 5-7 

536 S 31 AVE 

F2 

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 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 64.483 

Supervised By: 

Certificate of Verification 

5 

SOIL 

2011-01-20 13:44 

30.07 

Final 

22604 

536 S 31 AVE 

F2 

6" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 14.505 
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 90.824

Supervised By: 

Certificate of Verification 

6 

SOIL 

2011-01-20 13:44 

30.15 

Final 

22604 

536 S 31 AVE 

F2 

6" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 16.271 
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 85.800 

Supervised By: 

Certificate of Verification 

7 

SOIL 

2011-01-20 13:45 

30.07 

Final 

22604 

536 S 31 AVE 

F2 

6" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 16.198 
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 

12 

SOIL 

2011-01-20 13:48 

90.49 

Final 

Avg of 9-11 

536 S 31 AVE 

DZ 

13" 

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 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 101.627 

Supervised By: 

Certificate of Verification 

9 

SOIL 

2011-01-20 13:46 

30.15 

Final 

22604 

536 S 31 AVE 

DZ 

13" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 16.800 
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 116.474 

Supervised By: 

Certificate of Verification 

10 

SOIL 

2011-01-20 13:47 

30.19 

Final 

22604 

536 S 31 AVE 

DZ 

13" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 17.561 
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 87.366 

Supervised By: 

Certificate of Verification 

11 

SOIL 

2011-01- 20 13:48 

30.15 

Final 

22604 

536 S 31 AVE 

DZ 

13" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 15.819 
X 

/ ^ A A

" ^ '"iPHOi*^

 Omaha Lead Site—Fixed Price EP-R7-07-05 

Coastal Environmental Group Inc. 

 www.coastalhazmat.com 

 COASTA L ENViaONHINTAl 

CROUP , IH C 

EXECUTIVE SUMMARY: 

BVID # 22604 - (536 S 31 AVE) 

No Issues or Concerns [^ Issues/Concerns 

Detail Explanation: 

-DAN GARVEY WALKED THE PROPERTY ON 12/9/2010 
EPA Property Close Out Form 

Property tt: _ »3lbO<^ Property Addresr. -^kl—f_M_AiA -

Date/Time: Owner's Name- /• .r^^f<»..—V*jd|ff-. •:.• ;-. 

Quads ExcBV8l»d: \p ] \ ' ^ A V ^ Contractor Group _ 

Excavation Ve* No General 

1. If necessary, were the correct quadrantfs) excavaled and restored? / 

2. If necessary, were the correcl areas ofdrip zone excavated and restored'' y 

Grading Sod and Vegetation Ves ^o 

I Does the {rading around the perimeter ofthe house in excavaled areas generally slope away -yj-y _ from tfae house? 

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

i Docs the sod appear to be generally healthy and growing? (Only evaluaie if inspected ai a 30 /

day time period) ____ _ 

4. Are sodded areas generally firm and evenly graded? y^ ! 

 * I > Are the joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day y ' 

time period) 

6. Was the property graded such thai water will not pool on the property'' 

' 7 Was damage to landscaping or plant materials avoided? 

Gates, Ftpces aad Reuining Walls ____ ^ Ves Nil 

Do gates open and close freely? (Ifapplicable) 

+ - • 

2 Werc all gates or fences taken down during restoration activities reinstalled? (11 applicahlf) 

I -

I 3. Wasdamagelogatesor fences avoided? (Ifapplicable) / 

I 4 Wasdamage to retaining walls avoided? (Ifapplicable) 1/1 

Foupdation, SidiBRand GnUers ___ Yes No 

I I Was damage to the siding or trim avoided? 7 

2. Was damage to the foundation avoided'' 

HT .'. Was damage tc windows avoided'' 

/ _ 

4 Was damage to windows or door screens avoided? 

~^i\. \ 

1 ."^ Was damage to downspouts or downspoui exien.sions avoided'.' t _ __ _ ^ A I 

Sidewalks and Driveways (Concrete) Vc) Nr 

1. Was damage to driveway surfaces avoided? V 

2. Was darnage to walkway surfaces avoided" / 
OM-ners comments: 

i Fn.spection notes: 

Removal and resloration aclivaie.s compiete including the 30-day .sod warranry: 

\:.PA Rcpresenimivc 6<^ ^ Date: jj\=iVo 
<L. 

Property Completion Agreement 

I Ins agreemenl documenit. ihe compiclion ot remedial aclivmes perloimed on my pioperiy My signaluie 

will designate ihai I am sali.'.fied with the restoration of my properly, and lh?l no items are m quesiions 

now, or al any lime m the fulure. exccpl ihose iiems listed below, if any 

Property 10: _3L51^^V.^ 

Property Address; cSJik J5i_i-^ hA. Owner: AVr^ A>!AA 

I!:!!!!i-^-MBi^3^i-jmA-...... .. _ ^ J 

Restoration Items in Question: 

llem: 

Item: 

item: 

Item: 

Item: 

Additional Comments: 

. fl i ayrr r icstornlion is completed, ctctp l HS noleri 

\ ^iJ'-it o nn\ ^(jif c rr.sioiat)On js coni^lclci'l 

' t j /A ^ ^yA<f?.//// /^ -Ad 

•—Owiicr'.s Sigoatnrf y Date