TRANSMITTAL of OMAH A LEAD SITE 

SOIL REMEDIATIO N FILE FOLDER 

SAID#: Qf)^l< , Date: ^//R/c/y 

Address: ?,c^\h SPU^VTi ?^l 

Remediation Contractor: Coastal Environmental Group_ Year: 2008 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

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 Video of property (DVD) 

 Executive Summary 

 EPA-provided property sketch 

 Signed Access Agreement for subject property 

 Signed Access Agreement(s) for adjacent property 

 Restoration Agreement 

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

 Confirmation data 

 Photographs Or^'fy^ryiJaJlLD^j AJi^_^j)/tkiffl^ .fid ^

 As-built sketch 

 Satisfactory restoration signed by Property Owner 

 Property close-out check list signed by EPA 

 Description of areas not meeting ROD cleanup criteria 

 Utility clearances 

 Property information from Douglas County Assessor's Office 

 Sa d 

D 

S ^ CMJcQyA^ -Wvt/v-^ 

Signat Ignatur u e 'Date 
0

Property Access Checklist 

Property ID: 2-^3 ^ "7 ^ 

Property Address: ^^,P ^

Owner: C:, ^^c, 1 d\ n i ' Address:

Phone: Cb^5 - b2Cl?i 

F«x: 

Cell/Pager. 

D Notification Letter 

 Access Agreemenl 

• Restoration Agreement 

O Topsoil Sampling (if applicuble) 

CD DisposiU Sampling (if applicable) 

O GnrUcn Sampling (if applicable) 

ffl. Utility Clearance 

lil Video/Phofos (Before) 

D Video/Photos (During) 

n Video/Photos (After) 

D Video/Photos (30-Day) 

1 1 Property Completion Agreement 

D Final Report 

Air MonitorinK (as applicable ) 

n Community D Crew On:

RcsuJts: 

D Community' Q Crew On:

Results: 

• Community D Crew On:

Results: 

 C^p^^^^^S T 

 Yo»'^o^\ 

J 

D

D

 WORK STARTED

 WORK COMPELTED

 ON:

 ON:

 /

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 /_ 

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Renter 

Phone: 

FiL\: 

Cell/Pager: 

Additional Intormation: 

Sent: / / 

Signed: JL / ZV/O^) 

Signed: // /V-t /O ^ 

/ / 

/ / 

/ / 

Called: i|_/2^/LJ ^ 

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Issued:

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/ / 

/ / 

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By: KJ\0\C /BriQh 

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Omaha Lead Site 
Propeny ID ^

Property 

Address 

Initial Contaci: 

Second Conlact: 

Final Conlact: 

Final Aclion: 

Comment 

0\vner 

Cc^mment is] 

Site 

Coordinator 

Commeni (s! 

CONTACI FORM 

 eP^'^H ^ 

^ < S.V. 

Date _ Time: Aclion: 

Dale: Time: Action: 

Dale Time; Aclion; 

Transm t to EPA D Other Action: D 
Douglas County Account Infonmtion Page 1 of2 )j|mt 

Dougla s County , Nebrask a Propert y Recor d - R164135000 0 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 90th St - Vle W OP Ma p Information is valid as of 2008-11 -5 Treasurer's Tax Report 

New Feature -•-•• • Auto Sales Search 

Owne r 

YOUNG GERALDINE L 

3510 SEWARD ST 

OMAHA NE 68111-0000 

Propert y Informatio n 

Key Number: 4135 0000 16 

Account Type: Residential 

Parcel Number: 1641350000 

Parcel Address: 

Legal Description: 

3510 SEWARD ST 

OMAHA NE 68111-0000 

LOWES ADD LOT 11 BLOCK P E 40 FT 40 X 132 

Valu e Informatio n 

2008 

2007 

2006 

2005 

2004 

2003 

Land 

$2,400.00 

$2,400.00 

$2,400.00 

$2,400.00 

$2,400.00 

$2,400.00 

Improvement 

$46,900.00 

$46,900.00 

$46,900.00 

$46,900.00 

$17,800.00 

$17,800.00 

Total 

$49,300.00 

$49,300.00 

$49,300.00 

$49,300.00 

$20,200.00 

$20,200.00 

Lan d Informatio n 

Acres 

0.12 

SF 

5280.0 

Units 

1.0 

Depth 

132.0 

Width 

40.0 

Vacant 

No 

Improvemen t Informatio n 

Building 1 

http://douglasne.mapping-online.eom/DouglasCoNe/static/accountinfo.j sp?accountno=R 1... 11 /24/2008 
Douglas County Account Infoij^tio »a|^ n Page 2 of2 t 

3510 SEAARO ST 

OD i i 

i 

SCr 't«fta * no f Mff »v 

I 10 STORY FWI91ED 

CLICK TO ENLARGE IMAGE 

Square Footage: 1142.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Fair 

Built As: 1 1/2 Story Unfin Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 5.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: 1.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1900 0 0% 1900 108 

Detail Type Detail Description Units 

Add On Unfinished Attic W/floor 960.0 

Appliance Allowance 1.0 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 840.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Garage Detached 480.0 

Porch Slab Roof Ceil 168.0 

User NEW ROOF 3RD BR ON 2ND FL 1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl... 11/24/2008 
Page 1 of2 

"> 

Create Another Ticket Back to Irth Internet Send Email 

• YOUR TICKET NUMBER IS 2181426. 

Original Call Date: 11/24/08

Work to Begin Date: 12/01/08

 Time:

 Time:

 8:52 pm 

 7:15 am 

Op: ELIZABETH187 90 

State: NE 

Address: 3510 

County: DOUGLAS 

Street: SEWARD ST 

Place: OMAHA 

Twp: 15N

Twp:

 Rng: 13E

 Rng:

 Sect-Qtr: 16-NW,17-NE 

 Sect-Qtr: 

Legal Given: C 


Type of Work: lead remediation 


Location of Work: LOCATE ENTIRE PROPERTY INCLUDING HOUSE ALL THE WAY TO THE 


: STREET. 


Remarks: FAX ALL CLEARS TO: (877)662-4211 


Company : COASTAL ENVIRONMENTAL SERVICE 


Contact Name: ELIZABETH Phone: (877)662-4210 


Work Being Done For: coastal 


Depth of Excavation: 4ft Corner Lot: N Front: Y Rear: Y 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV LEVELS MCLEODNE MUDOl OMAHACOF OPPDGPRS QLNNEIC 


Service Area Contact Phone Number Utility 

Type 

CXCATV COX COMMUNICATIONS, 

INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

LEVEL3 LEVEL3 COMMUNICATIONS, 

LLC NA 

Day: 8773668344 

Alt: 

Emerg: 8773668344 

MCLEODNE MCLEODUSA NO NEED TO CALL OUT 

EMERGENCY 

Day: 8002891901 

Alt: 

Emerg: 8002891901 

MUDOl METROPOLITAN UTILITIES 

DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 11/24/2008 
Page 2 of2 

CITY OF OMAHA- OMAHACOF RON TRAFFICSEWER 

OPPDGPRS gj^^^^^^^''^'°'^^ ^ NA 

QLNNEIC QWEST LOCAL NETWORK NA 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

Alt: 8887289343 

Emerg: 4067289343 

Day: 4067289343 

Alt: 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 11 /24/2008 
As-Built Drawing 

C

ENVIRONMENTA

O AST A L 

L Omaha Lead Superfund Site GROUP , INC . 

Name: QeTaV^ f yvg '^' ^ *• Omaha Lead Site Date: t^fa-XI-ta; ^ North AfTow —1 

Address: "j-gic i c;«'«>ScMrfA %\- Site Sicetch Time: \:n a arr ^ 

Phone: t^n1. ~ <5S-i ^ MClg ? 1 

? « 0 (vvjccciH; 

Team C^r.ol A ( <^V^/^Lt.^^r. BVID#_2_59_rLS - XRF Code S'^0\ 

Sample Number Lead Concentration Confimnation Sample 

^^Am>x/ \ - zy f 75-­ ppm p,Yes n No ^ 

ppm t^yes a No 9SI 

ppm ft,Yes • No g 

ppm ares a No g 

ppm No ?3 

ppm Yes n No • 

ppm Yes n No • 

OLS#: 2597S 

feate Excavated: 121/6/200$ 

Dat0 USEPA Signed Off: 1/27/2008 

. i Area [Sodded 244gsqft i 

B2 = 38 PPM @ 6" B l = 63 PPM ( 

DZ = 380PPM@13 " 

F2 = 42 PPM @ 6" 

EA=170PPM(ai " 

Omaha Lead Site 46130 

Legen d 

Concrete Drip Zone Excavated Quadrants Excavated 

Area replaced

Sod 

 with Area replaced with 

Rock/Mulch Area left bar e 

Contrac t #: EP-R7-07-05 Coasta l Environmenta l Group Inc . 
Name: C|eTaV«^ f |^e '^feoNO L Omaha Lead Site Date: fb^-\n-6' ^ North Arrow 

Address: -ggsvo cu»V)CMrA % ^ Site Sitetch Time: _LlQajQJn 

Phone: f^n'i. ^ g^t - t,'LC{^ I 

9 « D iVVjcocvXt 

Team C|ftol/A ( <^Vv/gJlVUei BVID#

Sample Number 

k^^lL^CpXA ­

(?)l't> *>^PX.R " 

2y*-/S -

tS-TVS-

/eD^S^rPxA- 2S^^7 r 

2 ^^Q n C 

Lead Concentratioon

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

XRF Code S"SO\ 

Confirmation Sample 

p,Yes n 

t^e s n 

ft,Yes n 

a^es n 

l^tes CD 

Yes n 

Yes • 

No ?l 

No 9D 

No g 

No g No ^ 

No a 

No • 

2, 

rs 

i 

.|a.l.lfti;.ii 

0 

S 

1 

0^ 

4 

 *_ j J ^ ^ /• ^^^ / I i t / \ J -Lj i1 iicoCtzL 

Omaha Lead Site 46130 
Name: CieYaV«Af r>e VooNq L Omaha Lead Site Date: r>^-\n-fe' ^ North Arrow 

Address: 'a.g5\c» <i^^ojr A %V Site Si^etch Time: \'.nQ pT n 

Phone: Ai»rL - tS^-^ ^ (..l tue 1 

9 S 0 (WJOOCC^C 

Team C^ts^\ A ( <^Vv^gJLM^ BV1D# 2 5 ^ -\' 5 XRF Code S"SO l 

Sample Number Lead Concentration Confirmation Sample 

^?A5£PXA -2s-f75 ­

pyHi.cf'XA ­ 7-«r»-ryR'}^t^<,cpxt^ ­ •Zj^f-rS 

1^*^^' ^ 

fc?7t zv 

ppm 

ppm 

ppm 

P,Yes

^jYes

^,Yes

 1=1 

n 

n 

ppm 

ppm 

ppm Yes n 

ppm Yes • 

11 

ll 

Ii 

ii. j-^e— ^ 

-U- SVv*- ^ 

7 i6'77 m , f qoiit- iz I 3 -^ft-«=­ ' > i 6 

V- u 

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Omaha Lead Site 46130 
y^* * m COASTA L 

%,« ENVIKONntNTA l ^ C • O U ' . IM C 

Consent For 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: (^ev^cOs^ v v\JL Daytime Phone: 

SSI ~(pff<ffi 

^ 

Address of Property 

covered by this 

Agreement: cfb\ ^ %eju-^o~yC^ % t 

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 soil. 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, will 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 will receive written 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 
COASTA L INVIflOfinfNTAL 

c I o u r, IMC 

• Remove obstructions Including boats, trailers, vehicles, playscape items, wood 

piles, dog houses, etc; 

• Remove flower bulbs or plants that the Grantor or the Grantor's tenant may wish 

to save; 

• Water and maintain replacement vegetation, including fertilizer application, as 

necessary subsequent to an initial watering period by EPA; 

• Abide by health and safety guidance provided by EPA; 

• If the property is rented, assist EPA in obtaining tenant approval for access to 

the property to perform the work. 

• 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 (712) 352-0188 

1° 'grant access to my properties D I do not grant access to my properties 

Signature Signaafur l e Date 

O I would like to be present during any sampling that is required. 
Restoration Agreement 

The purpose ofthis agreement is to provide a mutual 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 propertv' owner and the United States Environmental 

Protection Agency (EPA). 

Property ID: Qe^qq^ ^ 

Property Address: 5^> ^ ^ ^ ^ ^^^ ^ r rj^ ^^ , . 

Owner: (:^^ ^^^3^^^^^, ^ ^^ ^ ^ 

Phone: c-r-? - / TOO ^T 3 -^;?9e 0 

On the attached diagram(s) indicate area(s) to excavated and depth of excavation, location of all known 

utilities, subsurface features, syrface structures and landscaping features, access location(s) to be used by 

contractor, and the direction of North. Indicate distances, depths, material types, etc. Indicate digital photos 

by referencing the photo-log number with an arrow indicating direction of view. 

Items To Be Removed By Owner Before Start Of Remediation: 

(Use additional sheets as necessary) 

The removal, storage, disposal, and/or return of these items is the Owner's responsibility. 

Item: / 

y 

Item: 

Item: 

z: 7 

Page i o f U? 
COASTA L 

C A D W P . IN C 

Items To Be Removed By Contractor During Remediation And Not Replaced 

(Use additional sheets as necessary) 

Item: 

Aticj ^'^hr^ s 

Hem: 

Item 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Hem: 

Item: 

Item: 

Item: 

Hem; 

Page 2 o\Ap_ 
COASTA L 

C M O U r IN C 

Items To Be Removed By Contractor During Remediation And Replaced 

(Use additional sheets as necessary) 

Item: 

.<;^,/- F-.a -Kl~fl2- b 

Item: 

yy^'F^-RZ-I^l-O^ 

Item: 

Pf^n4s fCTr-e<.ns ) 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 3 of_ ^ 
COASTA L 

Item 

Landscape Inventory 

(Use additional sheets as necessary) 

Quantity Unit Condition/Type/Species 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Square feet 

Number of trees > 2 inch 

trunk diameter 

Each 

Number of trees <= 2 inch 

trxink diameter 

Each 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Attach a sketch of the 

sprinkler layout. 

Each 

Number of and size of 

each garden/ flower bed 

area. 

Attach a sketch of relative 

sizes and locations. 

? Each 

Square Feet 

'To })•€ d'£.T^t^/yitnet / 

Page 4 of_ 
- • - *» • 

COASTA L 

Item 

Agreed upon value of 

Dlant materials not to be 

replaced bv contractor. 

Note this value will be 

used to issue a plant 

voucher to the property 

owner. 

Agreed upon list of plant 

materials that will be 

replaced by conrractor. Be 

very specific and detailed. 

Include a sketch of were 

each plant will be placed 

by the contractor. 

Agreed upon area of 

property to be replaced 

with grass sod. 

Include a sketch of the 

area(s) to be replaced with 

grass sod. 

Area of City or County 

property to be landscaped 

per their requirements. 

Include a sketch of the 

aiea (s) 

Easement Area, to be 

excavated 

Quantity Uriit Condition/Type/Species 

r 

^OO.^'^ 

To b e ot^e^c /Ht >-i^^ 

f. 

Each 

D5: 

SF 

/ SF 

is'^ SF 

~r^ 'oe d<2riQ<n\ n^ ^ 

Page 5 of ^ 
C O A S T A L • MVItkOKHCMTAL 

Q Check the box if Owner does not want CEG to documerrt interior foundation walls and possible 

pre-existing damage. By checking Biis box CEG is not responsible for any damage done to the 

interior of house, indudingfoundation cracks or fissures. 

• I do not agree 

>ivner's Sigoature / / DattP-, ' Contractc^s Signatnre Date 

PageSof. 
BVlD#c36^"7fr 

XRF PROPERTY SAMPLE SHEET 

Dale \Q-i.-^- ^ Address .^f^||--> Sf i yDCx^r\\4: . 

Project Omatia lead FP 2na year opiion Sample time am/pm ii-g ^ 

XRF ID# sample length 30 sec ,^^og^z, r 

Shot# Reading Sample area Shot# Reading Sample area 

^8lD ^ ;^,^.~IH i iq-XD <^.^1 Q U 3 . .^ ^ tq-o a F'Q ^^(oP > n s .«ctt u . 3 0 ft*^^"" A«'7.2 ; JT .>¥=> t - I ;^q 

^AP^i^H iu« if.^i. Ki-;^?, Depth ^.B-?4 .^T.^a t «T 4 Depth 

^BioH Kv<^.^ t |-I.$3 1 HBl-^ f,^.;.,F, "- vO..;> O 

Average |^0 . ^'^M J: l,(_ff.n ^ Average 4- ^ •;3 ^ t R Q U 

Shot # Reading Sample area Shot# Reading Sample area 

^«T T .'.,; ,-^i^ ^ U-S-H ^<^B7 ..jt^r-, ..L-.^iq . .ci-N 

^4A-7 ^ (.o.l^^ i u.eQS- ?>! ^^:^B8 ^T?s.-7Pt.l^.7 ^ ti^ 

Depth ^/^-T ^ •^u-^^i, t lo.'^t^ 4 g ^ ^.c i • q q t .y.n^ r Depth 

^fiBD - , 7.o^'--IO.O T (t? '^gy^t^ k-.^.f>fei:--.!.>:: .22_ 

Average (g ^ r^i i l \ .p ^ Average .^^^ H .€S^ , t <^.^ . ^< , 

Shot* Reading Sample area Shot*' Reading Sample area 

'^g'^i © ^.-S.MHt 8? ^ 

^o u i. ^ . O &Q ^m. ^ 

AR^ 4.iiv<i,\ t. '^i.af\ Depth a Depth 

^P^ct' ^ ^ 1 m^ . 8 7H- ( P 

Average .^8.^ ^ t , 8 • " ^ A Average 

RETEST AREAS 

Shot# Reading Sample area Sho1# Reading Sample area 

Depth Depth 

Average Average 

lab sample M Lab result Sample area XRF Avg. 

Signature, 

Print y y f <^g> l<^ 5 10/?(^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 142.791 

Supervised By: 

Certificate of Verification 

4867 

SOIL 

2008-12-06 11:45 

30.58 

Final 

25975 

3510 sew^ard 

easement 

Ventry 

1 

CLEARANCE 

± Error 

± 14.803 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 175.887 

Supervised By: 

Certificate of Verification 

4868 

SOIL 

2008-12-06 11:46 

30.48 

Final 

25975 

3510 seward 

easement 

Ventry 

1 

CLEARANCE 

± Error 

± 16.204 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 168.784 

Supervised By: 

Certificate of Verification 

4869 

SOIL 

2008-12-06 11:47 

30.79 

Final 

25975 

3510 sew/ard 

easement 

Ventry 

1 

CLEARANCE 

± Error 

± 15.829 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 195.251 

Supervised By: 

Certificate of Verification 

4870 

SOIL 

2008-12-06 11:47 

31.34 

Final 

25975 

3510 seward 

easement 

Ventry 

1 

CLEARANCE 

± Error 

± 17.222 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4871 

Mode SOIL 

Time 2008-12-06 11:47 

Duration 123.19 

Sequence Final 

Flags 

AVERAGE Avg of 4867-4870 

ADDRESS 3510 seward 

QUAD/ZONE easement 

INSPECTOR * Ventry 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 170.678 ± 16.015 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 42.345 

Supervised By: 

Certificate of Verification 

4872 

SOIL 

2008-12-06 11:48 

30.51 

Final 

25975 

3510 seward 

F2 

Ventry 

6 

CLEARANCE 

± Error 

± 9.019 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 27.884 

Supervised By: 

Certificate of Verification 

4873 

SOIL 

2008-12-06 11:49 

36.09 

Final 

25975 

3510 seward 

F2 

Ventry 

6 

CLEARANCE 

± Error 

± 7.887 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 39.921 

Supervised By: 

Certificate of Verification 

4874 

SOIL 

2008-12-06 11:50 

30.09 

Final 

25975 

3510 seward 

F2 

Ventry 

6 

CLEARANCE 

± Error 

± 8.739 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4875 

Mode SOIL 

Time 2008-12-06 11:50 

Duration 30.46 

Sequence Final 

Flags 

BVID # 25975 

ADDRESS 3510 seward 

QUAD/ZONE F2 

INSPECTOR Ventry 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 58.681 ± 10.096 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4876 

Mode SOIL 

Time 2008-12-06 11:50 

Duration 127.15 

Sequence Final 

Flags 

AVERAGE Avg of 4872-4875_ 

ADDRESS 3510 seward 

QUAD/ZONE |F 2 

INSPECTOR Ventry 

DEPTH 6 

SAMPLE TYPE ' CLEARANCE 

NOTE 

Pb 

Supervised By 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 66.029 

Supervised By: 

Certificate of Verification 

4877 

SOIL 

2008-12-06 11:51 

30.67 

Final 

25975 

3510 seward 

Bl 

Ventry 

6 

CLEARANCE 

± Error 

± 11.843 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 62.190 

Supervised By: 

Certificate of Verification 

4878 

SOIL 

2008-12-06 11:52 

30.73 

Final 

25975 

3510 seward 

Bl 

Ventry 

6 

CLEARANCE 

± Error 

± 11.246 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4879 

Mode SOIL 

Time 2008-12-06 11:53 

Duration 30.89 

Sequence Final 

Flags 

BVID # 25975 

ADDRESS 3510 seward 

QUAD/ZONE Bl 

INSPECTOR Ventry 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 66.887 ± 10.951 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4880 

Mode SOIL 

Time 2008-12-06 11:53 

Duration 30.88 

Sequence Final 

Flags 

BVID # 25975 

ADDRESS 3510 seward 

QUAD/ZONE Bl 

INSPECTOR Ventry 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 57.087 ± 10.269 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4881 

Mode SOIL 

Time 2008-12-06 11:53 

Duration 123.17 

Sequence Final 

Flags 

AVERAGE Avg of 4877-4880 

ADDRESS 3510 seward 

QUAD/ZONE I Bl 

INSPECTOR Ventry 

DEPTH 

SAMPLE TYPE CLEARANCE 

NOTE 

Pb 

Supervised By: ^^=<: ^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4887 

Mode SOIL 

Time 2008-12-06 11:59 

Duration 30.90 

Sequence Final 

Flags 

BVID # 25975 

ADDRESS 3510 seward 

QUAD/ZONE DZ 

INSPECTOR Ventry 

DEPTH 13 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 265.597 ± 19.206 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 273.698 

Supervised By: 

Certificate of Verification 

4888 

SOIL 

2008-12-06 12:00 

30.65 

Final 

25975 

3510 seward 

DZ 

Ventry 

13 

CLEARANCE 

± Error 

± 19.782 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 469.488 

Supervised By: 

Certificate of Verification 

4889 

SOIL 

2008-12-06 12:00 

30.65 

Final 

25975 

3510 seward 

DZ 

Ventry 

13 

CLEARANCE 

± Error 

± 25.747 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 513.577 

Supervised By: 

Certificate of Verification 

4890 

SOIL 

2008-12-06 12:01 

30.61 

Final 

25975 

3510 seward 

DZ 

Ventry 

13 

CLEARANCE 

± Error 

± 27.116 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4891 

Mode SOIL 

Time 2008-12-06 12:01 

Duration 122.81 

Sequence Final 

Flags 

AVERAGE Avg of 4887-4890 

ADDRESS 3510 seward 

QUAD/ZONE ?DZ 

INSPECTOR Ventry 

DEPTH : 13 

SAMPLE TYPE CLEARANCE 

NOTE 

Pb 

Supervised By 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4892 

Mode SOIL 

Time 2008-12-06 12:02 

Duration 31.96 

Sequence Final 

Flags 

BVID # 25975 

ADDRESS 3510 seward 

QUAD/ZONE B2 

INSPECTOR Ventry 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 33.492 ± 8.495 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4893 

Mode SOIL 

Time 2008-12-06 12:03 

Duration 30.97 

Sequence Final 

Flags 

BVID # 25975 

ADDRESS 3510 seward 

QUAD/ZONE B2 

INSPECTOR Ventry 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 40.113 ± 9.120 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 44.906 

Supervised By: 

Certificate of Verification 

4894 

SOIL 

2008-12-06 12:04 

30.95 

Final 

25975 

3510 seward 

B2 

Ventry 

6 

CLEARANCE 

± Error 

± 9.385 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4895 

Mode SOIL 

Time 2008-12-06 12:04 

Duration 31.19 

Sequence Final 

Flags 

BVID # 25975 

ADDRESS 3510 seward 

QUAD/ZONE B2 

INSPECTOR Ventry 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 37.066 ± 8.741 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4896 

Mode SOIL 

Time 2008-12-06 12:04 

Duration 125.07 

Sequence Final 

Flags 

AVERAGE Avg of 4892-4895 

ADDRESS 3510 seward 

QUAD/ZONE fB 2 

INSPECTOR Ventry 

DEPTH 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb |_38.894 ± 8.936 

Supervised By: 
f>^fJL\ Omaha Lead Site—Fixed Price EP-R7-07-05 ^ J^^^ L I Coastal Environmental Group Inc. 

C^^^T^ * www.coastalhazmat.com 

^"iPHoT*"' COASTA L ENVIRONHENTAL 

G tt 0 U r , INC . 

EXECUTIVE SUMMARY: 

BVID # 25975 - (3510 SEWARD ST) 

I I No Issues or Concerns ^ Issues/Concerns 

Detail Explanation: 

MS. YOUNG RECEIVED A $200 FOR THE REPLACEMENT OF PLANTS THAT WHERE 

DESTROYED DURING THE REMOVAL OF LEAD IMPACTED SOIL FROM THE HOME. 
^^EPA 

EPA Property Close Out Form 

Property #: rO^q^nCT Property A6Ar^.<^\^ \ ^ ^ ^ff^ ^ ' 

Datc/Tinic: Owner's Name: 

Quads Excavated: F^ , 'g^V^F.c ^ ^ ^^?-, Contractor Group 

Excavation Yes No General 

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

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

Yes No 

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

Grading Sod and Vegetation 

y from the house? 

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

3. Does the sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 

y day time period) 

4. Are sodded areas generally fum and evenly graded? / 

5. Ajie 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 that water will not pool on the propeny? y 

7. Was damage to landscaping or plant materials avoided? y 

Gates, Fences and Retaining Wails Yes No 

I. Do gates open and clo.se freely? (Ifapplicable) 

2. Were all gates or fences taken down during restoration activities reinstalled? (Ifapplicable) iJ ^ 

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

4. Was damage to retaining walls avoided? (Ifapplicable) / 

Foundation, Siding and Gutters 

1 

I. Was damage to the siding or trim avoided? 

Yes 

y 

No 

2. Was damage to the foundation avoided? y 

3. Was damage lo windows avoided? 

4 Was damage to windows or door screens avoided? 

y 

y 

5. Was damage to downspouts or downspoul extensions avoided? y 

Sidewalks and Driveways (Concrete) Yes No 

1. Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 

y 

V 
Ov^ners comments: 

Inspection notes: 

Removal and resloration activates complete including the 30-day sod warranry: 

EPA Representativ;^^;^.^?}!,^^^^^^ JL ^ Date: '/jiy/s? 
Property Completion Agreement 

This agreement documents the complclion of remedial activities perlbrmai on my property. My signature 

will designate Ihat 1 am .salislied with the restoration of my property, and that no item.s aie in qucstion-s, 

now, or at any time in the future, except those item.s li.sled below, ifany. 

P.opc.tyjIh^<2-^j. 

ll!Il!''l'^11JSV 0 Seu^r J ^ f _ 

^.^'""'^ 6. ^rc^U.:^s. Vocet>3__. 

Restoration Items in Question: 

I Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

VoacJoeC n 

L 

"FHla t ttrce restoration i.s complotcd, excepi as noted 

I l/ydo not agroo resloration is completed 

/^//o/^f 

f'jjmractor's .Signature Date 
Property Damage Settlement 

Property ID 25975 

Property Address 3510 Seward St 

Owner Geraldine Young 

Phone 402.553.6298 

I have received a check from the contractor, Coastal Environmental Group Inc. (Coastal), for the sum of 

$200.00 for the replacement cost of plants that where destroyed during the removal of lead-impacted soil 

from the property. 

Compensation Type Check 1686 

Value of Check $200.00 

Check to the Order of Geraldine Young 

Description of Damage 

Coastal Environmental Group will reimburse Ms. Young for the plants destroyed during the remediation for 

Lead at 3510 Seward St. 

My signature below acknowledges the receipt of the check listed above; further, I acknowledge that 

the compensation amount is fair for the replacement cost of the plants and release Coastal 

Environmental Group, Inc. from further obligations or liability related to this property. 

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