### CONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE 

# r:?'r:I

US Anny Corps

of Engineers


### ECC Certification for Property Closeout


### OLSID 29911 Property Address 1825 Locust St. Field Work Started 9/27/2007 Field Work Completed 9/28/2007 Summary: 

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

# • B1 excavation depth was 12 inches below ground surfaces. 

# • B2 excavation depth was 7 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.

Comments: None

### D~**IV~liIM** ECCQCM Title Date Jeff Hubbard USACE Con Rep 

# 11-, />-""1 Name Title Date

## 29911 Omaha L.ead SUe Ex erior Paint



### Team

_**-=~~~o:L::::._** __ 

### Quadrant Fl F2 B 

## 1---',-,Z.:-7:: B2



### EA-Nor'th

Phone: H:**--~----** Owner Name:btARY L TOlBERT 

# o GOOd 

### Site Sket<:h Address; .1625 LOCUST ST
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### rt:r'"Not pain 

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### XRF Code

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### __ Lead Concentration Date

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# 9/26107 _--!-:I**3~Z:::::;---!ppm** 7
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### CONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE 

# m

us Army Corps

of Engineers 

## .Eec. 

# "&'

Analytical Results Summary OLS # 

## 29911 1825 Locust St

Sample

Type Quadrant Depth Date Collected XRF Results (ppm) (avg.) 

### PX DE DE 81 0'<:: EA-N 

### I I 12 

### 7 0 

### II II 9/26/2007 9/26/2007 9/26/2007 

# I I 482 89 151

SAMPLE 10- SAMPLE ID 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-Excavation XRf 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 DripZone GA"'Garden PA'" Play Area EA '" Easement Depth describes the depth from which the sample was collected. ppm = parts per million

## page 1 

## of_ 

## c). 

# Cf'1/J 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) U.S. Environmental Protection Agency (EPA) has contracted the U.S. Anny Corps of Engineers (USACE), Omaha District to conduct environmental restoration services for the Omaha Lead Site. USACE Omaha is wor1<ing with Environmental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration services. Your cooperation is requested in giving EPA/USACE/ECC permission to access your property during the removallrestoration phase. For further information please contact Don Bahnke, EPA Project Manager at (913) 551­

003 or the Office of External Programs. at 1-800-223-0425.**;::":;~3** !-...:,:.:) ,**t,;~·.l '(;"~~a**  c'l :-:s;;,: -:CI**:;~: :(j'J~r**  jijrnt: 2 ; e:) :2':<.:::;



# 7 Property Access Granted 

### By

______ years

_____ years How long have you lived here? Has the exteior been painted or**cove~ed** with siding since 19787 DYes 

# o No Has the interior been painted or covered since 1978? DYes 

# o No

otal number of occupants:,
_ List Ages: 

## .-------------------Il List ages of occupants under 6 years old who play in the yard for 5 or more hours per week:,
_

omments:

. UTHORITY FOR ENVIRONMENTAL RESPON ACTIONS he 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 propef1y 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 akirg any response.acti.on under this IItle. or othefWise enforcing the prOVISIons of this title." Access Attempts: First:
_ Second: : Third: : _

# I pg._of_ 

# List of Existing Conditions Property Address: _\

# ~5 

# LaellDt OVO 10 

## # 

## Owner:

# Date:~ BVID# 

# QC\Q 

# II

Ref: 

### Photo # 

### Description

Owner Signature 

### ECC Print & 

### Sign Print & 

### Sign

### Contract No. W912DQ-04-D-0017, Task Order 

### DKOI Omaha Lead Site, Omaha, NE Property Closeout Agreement DVID Property Address 

# 1**/K~S-** 

## J-C1CiJ.s 

# r ,!Jq'l/I Property Owner Is 

### the Owner the Resident? DYes 

## mil /?; l( 

## To 1-8 

## eJe 

# r 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 A/USACEIECC 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 

### USACE and/or ECC:

CONTRACTOR CERTIFICATION 

### PrashaJ James D, Garcia ECC Project nager Charle: 

### J 

# . Date Name 

### Superintendant

# ~/)(~-. PROPERTY OWNER SECTION 

# "7l This agreement doc uments the completion of remedial/restoration efforts at the property to my satisfaction. 

# W I agree that restorati on is completed at my property, except as noted Comments (if 

### applicable):


# /0-**~7-** 0'7**)(vpJ~** 

# i,/f'A



# - ....... / 

### Property**Ow~r's** 

### Signature Date

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

__

### ---,j!5-~""'"""'C::;..(:lloJ:O:'--------------- Property Identifier Number:
_ Property BVID Number: 

# r 1/ j Property Address: 

## /8'4S'- /..L>(:lJs·r 

## 51 Property Owner's Name: 

# fTJf}-RYTOL8te 

# r (above infonnation to be filled out by remediation contractor prior to delivery of fonn to Property Owner) 

## *****************************************.******************. .** ***.*****. Instrodions 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. Anny 

### Corps of Engineers (USACE) are very interested in your opinion regarding the work performed 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 form 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 regarding Contractor's Work 10 

### 5 9 

### 4 8 

### 3 7 

### 2 6 1 

### Additional Comments from Prover1y Owner (optional; continue on back of page ifneeded)



### Property Owner's Signature: 

# ;<:ffi¥ 

# d,uJ Date: 

# /lJ -' 

# :J. 

# l:-iJ 

# 1