CONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE us Army Corps of Engineers
ECC Cel·tification for Property Closeout
OLSID 25030 Property Address 3165 Myrtle St Field Work Started 

### 9 /

512007 Field Work Completed 9/8/2007 Summary: 

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

## • Fl excavation depth was 5 inches below ground surfaces
. 

## • B I excavation depth was 6 inches below ground surfaces. 

## • B2 excavation depth was 7 inches below ground surfaces. 

## • Drip zone excavation depth was 13 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. 

# • Sod placement and site restoration were conducted in compliance with the specifications and work plans.

C omments: Per owners re quest: Shrub ( LIPI, 3' x 5', 34l pp m) was left in p lace. 

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## 't>.!1II,'; ECCOCM Title 

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# ~ J eff Hubbard USACE Con ReI:! 

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# ~ N ame Title Date SignatureNorth Arrow 

# - Address: 

## ?I?:S:A1<t1it?i2 Site Sketch Time : Phone: 

### t7 r- Name: 

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## e, Omaha Lead Site Date :

Team C 

### c.. J..Jdds OLS £DA Quadrant Lead Concentration FI

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### 5<e ppm

. F2 B 1---:-"-,,",---­ 210 ppm .. 131 ppm 

### B2 

### "1 " IS! ppm DZ Ii,'> 

### D!**61H'~' I~** **"** CfI - N Q " ,(gc.[ ppm 7 / 3 ppm 1 0 3 ppm IEJ4-W 0 h 7 0 ppm**~~V""&1** 

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Log Book 

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Omaha Lead Site 46130**'"Z.~O~b** 

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Omaha lead Site Omaha,NE Residential Yard Soils Environmental Restoration Services U.S. Environmental Protection Agency Region VII 

# • PROPERTY ACCESS (to be completed by property owner)**~a** a 'e:: J r 105'<1**'cr~a e~**  es>::,r':' ;::0' 'ave**; )~**  e a : cO] 22::**:>~::J** Environmental Protection Agency (EPA) has contracted the U.S. Anny Gorps of Engineers (USAGE), Omaha IDistrict to conduct environmental restoration services for the Omaha lead Site. USAGE Omaha is working with IIE1,vi.ronlm.,ntal Ghemical Gorporation (EGG) to remove lead contaminated soil and provide subsequent restoration 1Is,.rviices. Your cooperation is requested in giving EPA/USAGE/EGG permission to access your property during the**Dre,movaIJfre~'toratic)O** phase. For further information please contact Don Bahnke, EPA Project Manager at (913) 551· or the Office of External Programs, at 1·800·223·0425. Property Access Granted By

IIResident Name: 

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# m-/IIJ If /U IRes,idenceAddress:**s/~** 

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## y,€Tl..c (Please Print Name)

[JJ....mvner 

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HPrc)pertv Owned By:

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## ____________________**IIOwn'''~** mailing address:.

________________________________ 1I0vme,'s telephone number· Home:K 

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# t:f Work: -----------11 of Home? 

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# 5 I years How long have you lived here? the exteior been painted or covered with siding since 1978? the interior been painted or covered since t 978?

number of occupants: 

# 3 (P list rn--Yes**~Yes** 

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__ years 

# o No 

# o No

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

_______

activities to be implemented by EPA under this agreement are pursuant to Section 104 ofCERCLA. 42 U.S.C. 9604 EPA's right of access 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 action under this or olherNise the .. Access First:
__________ Second::
___________ Third::

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# List of Existing Conditions Property Address: 

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## Owner: TeRRI**/'v~RTt18N** 

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Ref: 

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Owner**Signatu~** 

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# e /---sContract No. W912DQ-04-D-0017, Task Order DKOI Omaha Lead Site, Omaha, NE Property Closeout Agreement BVID Property Address 

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# a NO Property Owner Is the Owner the Resident?

## ~ TE/Uc:r uJtJfh1V1/'f1l Compliance Statement: U.S. Environmental Protection Agency (EPA) has contracted the U.S. Army Corps of Engineers (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 AlUSACElECC 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 Extema 

### I Programs at 1-800-223-0425. Additional Comments by USACE and/or ECC:

CONTRACTOR CERTIFICATION ECC Project Manager Date Signature Name Title 

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

## '~Iagree that restoration is completed at my propertY, except as noted 

# . Comments (if**icable):** 

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## /.;0/~**C,7 7**  Date f f Property Owner's Signature

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

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______________ Property Identmer Number:

________ Property BVID Number: 

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( above information to be filled out by remediation contractor prior to delivery of form to Property O""er) 

### Instmdions to Property Owner: This fonn is provided to you as a means of trying to 

### capture your level of satisfaction with the work ofthe 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 perfonned by our contractors. This fonn 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 fonn and return 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 . ) 9-10 "excellent " 7-8 "very good " 5-6 "acceptable" 3-4 "poor" 1-2 "very poor" 

### Property Owner's Satisfaction Rating regardjng Contractor's Work 10 5 9 4 8 3 7 2 6 1 

### Additional Comments from Property Owoer (oPtional; continue on back of pm 

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Property Owner's Signature:

# )(~!4E=-. Date: ICONTRACT 

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

### Analytical Results Summary OLS#25030 3165 Myrtle St
Quadrant Sample Type Depth Date Collected XRF Results (ppm) (avg.) 

### DE F1 5 9/7/2007 56 

### DE 81 6 9/7/2007 131 

### DE 82' 7 9/7/2007 152 

### DE DZ 13 9/7/2007 164 

### DE DZ-G 13 91712007 713 

### DE EA-N 0 9/7/2007 103 

### DE EA-W 0 9/7/2007 70 

### DE L1P1 0 9/7/2007 341

SAMrLE 1))- SAMPLE lD is 3 particular residential properLy ID from which the sample is collected. The sample type Identilier (with sequential sample number for that location) as follows ; PX :2 Pre·Exc3v8lion XRF sample DE

- During and Post ExcavatIOn Quadrant desCribes the sampling location (with sequcnllal sample number for thai location) as follows; Fl Or F2 - roTan! Yard One or Front Yard Two B 1 or B2 - Back Yard One or Back Yard Two DZ

- Drip Z one GA ::::: Garden PA

- Play Area EA • Easement Depth deSCribes the depth from which the sample was collected
. ppm - parts pcr million

# ECC OWNER CHANGE REQUEST FORM**!..1/~t'** ________ PROPERTY

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ACTION TAKEN :

SUPERVISOR INITIAL

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