CONTRACT # EP-R7-06-04

 

ASW Associates Inc. 

Omaha Lead Site Remediation, Omaha, NE 

EPA 

ASW Associates Inc Certification for Property Closeout 

BVID 22713 Property Address 529 S 27 St 

Field Work Started 12-Jun-06 Field Work Completed 27-Jul-06 

Summary: 

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

The B1 quadrant was excavated to a depth of 12 inch. 

The drip zone was excavated to a depth of 12 inch. 

Verification samples confirmed that the cleanup standards were met. 

The site was backfilled with materials which meets contract specifications. 

The backfill was compacted to acceptable standards. 

Sod placements and site restorations were conducted in compliance with work plans and

 

specifications. 

• Analytical data provided is post excavation at the bottom of the excavation for confirmation 

purposes 

Comments: 

The garden zone was excavated to a depth of 12 inches. 

Jan Prawdzik ASW Project Manager 

Name Title 'Date gnatur 

40261987 

SUPERFUND RECORDS 
CONTRACT # EP-R7-06-04 

ASW Associates Inc. 

Omaha Lead Site Remediation, Omaha, NE 

EPA 

Analytical Result Summary 

OLS ID: 22713 

Property Address: 529 South 27th Street 

XRF Results Lab Results Sample ID Avg. (ppm) (ppm) 

22713-DE-B1-12 142.3 ± 35.6 NA 

22713-DE-DZ-12 156.3 ±42.6 NA 

22713-DE-UC-12 73.4 ±41.6 NA 

Jan Prawdzik ASW Project Manager 

Name Title Dae 

Sample Damnation 

OLSID-DE-Location-dd 

OLS1O is a particular residential property ID from which the sample is collected. 

DE - During and Post Excavation 

Location of the sample as follows;

 

Fl = Front Yard (1* Quadrant) 

Ql - Back Yard (I*Quadrant) F2 - Front Yard (2°< Quadrant)

 

B2 - Front Yard (2* Quadrant) 

DZ • Drip Zone 

PZ = Play Zone 

GA = Garden 

EA = Easement 

dd describes the depth from which the sample was collected, 

- NA= Not Applicable 
&EPA

 

Remediation/Excavation Contract (ASW) 

EPA Property Close Out Form 

Property #: __ Property Address: 3'2*

 

Date/Time: Owner's Name:

 

Quads Excavate871_ Contractor Group

 

Excavation General 

1 . If necessary, were the correct quadrant(s) excavated and restored? 

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

Grading Sod and Vegetation 

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

from the house? 

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 

day time period) 

4. Are sodded areas generally firm and evenly graded? 

5. Are the joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day 

time period) 

6. Was the property graded such that water will not pool on the properly? 

1. Was damage to landscaping or plant materials avoided? 

Gates, Fences and Retaining Walls

1. Do gates open and close freely? (ff applicable) 

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

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

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

Foundation, Siding and Gutters

1 . Was damage to the siding or trim avoided? 

2. Was damage to the foundation avoided? 

3. Was damage to windows avoided? 

4. Was damage to windows or door screens avoided? 

5. Was damage to downspouts or downspout extensions avoided? 

Sidewalks and Driveways (Concrete)

1 . Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 

Yes No 

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Yes No 

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 Yes No 

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 Yes No 

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 Yes No 

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Owners comments: 

Inspection notes: 

niy ' 

stc '3 *-

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

EPA Representative _ &^ ^ _ Date: 
Contract No: EP - R7 - 06 - 04 s Property Closeout Agreement |w| Omaha Lead Superfund Site 

OLSID Property Address 

52? S. j-to*-

Property Owner Is the Resident the Owner D Yes H- No Alia* S«U«o 

Compliance Statement: 

U.S. Environmental Protection Agency (EPA) or its authorized representatives, (or its contractors), to enter 

and conduct environmental restoration services for the Omaha Lead Site. 

Your cooperation in giving EPA/ASW 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 contact specifications and EPA requirements. 

If you have questions or need additional information please contact the EPA Public Information Centers at 

(402) 731-3045 or (402) 991-9583 or the EPA Office of External Programs at 1-800-223-0425. 

Additional Comments by EPA and/or ASW: 

CONTRACTOR CERTIFICATION 

Jan Prawdzlk ASW Project Manager 

Name Title Date Signature 

Property Owner Section 

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

{B- 1 agree that restoration is completed at my property 

D I Do Not Agree: Comments: 

07 /2_$ / o (o ^rt^iY^, i 3 1 Property OWrifSreignature I Date 

y i 1 A i Jt *f 1 

^&As\ ^^6(AA^\^\7^^ cTjI^&fo ( TM * 1 ^^" VJ I 

/ EPA Representative Signature ' Date 
Page 1 of 

Omaha Lead Site 

Omaha, NE 

U.S. Environmental Protection Agency Region VII 

Residential Yard Soils 

Environmental Restoration 

Services 

Grantor (the property owner), consents to and authorizes the United Sates Environmental Protection Agency (USEPA) 

or its authorized representatives (or its contractors), the Grantee, to enter and perform certain environmental response 

activities upon the following described premises. For further information please contact EPA at 1-800-223-0425. 

Property Access Granted By Cn £j ^3 H( t x31 C 

(Please Print Name) 

(Property Owner Signature) (Date) 

NOTE: Granting permission DOES NOT necessarily imply your property will be remediated at this time. 

Residence Address: 

(CITY) (STATE) (ZIP) 

Property owned by: 

Owners mailing address:_ 

Owner's telephone number—Home: S~ Y >­ c

ft / 7 

Age of Home? / /&_ years How long have you lived here? f "^*^ years 

Has the exterior been painted or covered with siding since 1978 IJr YES

 

Has the interior been painted or covered since 1978? ErYES D NO

 

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: 

Comments: 

AUTHORITY FOR ENVIORNMENTAL RESPONSE ACTIONS 

The 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 to the property for in Section I04(e) ofCERCLA, 42 U.S.C. 9604 (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: 
List of existing Conditions pg. _ of _ 

Property Address:

Owner: /f/^fs

Description: 

 5" 7-1

 5t/f<fc

 J». 

 Date: *>l-2-Y'tf OLS#: tt 7 // 

Owner Signature: ASW Associates Inc. 

Print & Sign Print & Sign 
22713

 

Omah Exterior Paint North Arrow Owne a Lead Site r Name: ALBETO SALCEDO [3 Good Site Sketch Addro««:529S27ST [3 Poor

 

Phone:

 H- 402-553-4697 W:

 0^ Not paint 

Sample Lead Bar nple ..„ Samples Collected Number

Concentration c:oil< scted Firm: /C

'A4 MCT //6cJ 

.fWAGCPXA 22713 PH " I3pm D D Dat 6- /i. *• /z~<r 

•RYB60PXA'S£71Q P2- "" ijpm D D Tim 6' //'^S~

 

RYCSCPXA-22713 B1 mo i>pm & D

 Samples Analyzed ijpm n n 

RDZSCPXA-22713 DZ (o&O ppm ET D XRFUnit 1091 Book: /•/^ 

RGZSCPXA-22713 GZ 112*1 Dom 0r D Date:

 /-/7-^ t .. RP2SCPXA 22710 P2~ ijpm D n Tim y P/Y\

 

Stal t 2->l Number of SB mples- i:J] LEJ 

Legend: F1= Front Left, F2 * Front Right, B1= Back Left, B2= Back Right DZ= Drip Zone, GZ = Garden, PZ= Play 

All quadrants are as vlewwd from the street, facing property 

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