TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: 2Q^')r 5 Date: 5-ZQ'H 

Address: \{Mp hf^fj ^ ^ 

Remediation Contractor: Coastal Environmental Group Year: 2010ARRA 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) 

vr 

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 

As-built sketch 

y ^ Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 

Description ofareas not meeting ROD cleanup criteria 

Utility clearances 

Property information from Douglas County Assessor's Office 

C l ^ h 

signature 

Date 

30261020 

Superfund 
VV 

Property Access Checklist 

Property ID: >p^Z> n WORK STARTED ON: __/__/_ 

Property Address: D WORKCOMPELTED ON: / / 'y(d' ZZMZiL^p^ ^ 

Q^"*"" Renter: ' Pyt/^'pe-r^M- lOPT^n 

Address: Pbone: 

lUfPS^ ipcv^ ^ ^ ^ Fax: 

Cell/Pager: CfppPbfP^ i/te.(j2Z1(D 

Additional Information: Phone: PPil^-k(e^ i J A, /. P F 3 -

Fax: 

c.ii/P.g.. 41tA ' ^.C ^ [/r,j^rk.\ 

n Notification Letter Sent: / / By: 

^^jP Access Agreement Signed: g^/J^// ^ By= N..c> 

P P Restoration Agreement Signed:/^/^^ / O By- V.W.. 

ID Topsoil Sampling (if applicable) 1 1 By: 

Q Disposal Sampling (if applicable) 1 1 By: 

• Garden Sampling (if applicable) 1 1 By: 

[^ Utility Clearance CaUed: n / 9,1\ ^ 

By=u/. „/ , 0 u* ^ 

^ Video/Photos (Before) On : \ o / -So / V.O 

By= siv^ ^ ' 

D Video/Photos (During) On: / / By: 

n Video/Photos (After) On: / / By: 

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

• Property Completion Agreement Signed: / / By: 

D Final Report Issued: / / By: 

Air Monitoring (as applicable) 

n Communitv f") Crew On: / / By: 

Results: 

n Community • Crew On: / / By: 

Results: 

• Community • Crew On: / / By: 

Results: 

Omaha Lead Site 
Douglas County Account \n Page 1 of2 

^ 

Douglas County, Nebraska Property Record - R1744660000 

Print Reoort 

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

New Feature r* r> r¥. Subdivision Sales Search 

Owner 

DUNN ROSSEVELT 

1605 LOCUST ST 

0IV1AHANE 68110-0000 

Property Informatio n 

Key Number: 4466 0000 17 

Account Type: Residential 

Parcel Number: 1744660000 

Parcel Address: 1606 MAPLE ST 

OMAHA NE 68110-0000 

Legal Description: MILLARD & CALDWELL'S ADD LOT 21 BLOCK 0 W 30 E 120 N 71.625 FH" 30 X 

71.625 

Value Informatio n 

2010 

2009 

2008 

2007 

2006 

2005 

Land 

$200.00 

$200.00 

$200.00 

$200.00 

$200.00 

$200.00 

Improvement 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

Total 

$200.00 

$200.00 

$200.00 

$200.00 

$200.00 

$200.00 

Show All Transactions 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.04 2130.0 0.0 71 :o 30.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl 7... 9/15/2010 
3/31/2011 www.dhon.org/irthintemet/DHONNotic.i 

Create-Another-Tlcket Back -TWrti h-Intemet- r Send-EmajF] 

• YOUR TICKET NUMBER IS 2700079. 

Original Call Date: 3/31/11 Time: 1:20 pm op: ALFONS018790 


Work to Begin Date: 4/04/11 Time: 1:45 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 1606 Street: MAPLE ST 


Twp: 15N Rng: 13E Sect-Qtr: 10-NE-NW-SE-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: (402)934-2811 


: PLEASE INCLUDE ALL EASEMENTS 


Company : COASTAL ENVIRONMENTAL SERVICE 


Contact Name: ALFONSO Phone: (402)934-2837 


Work Being Done For: Coastal 


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


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Utility Service Area Contact Phone Number Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEEDI Alt: 4029340469 

Emerg: 4029329757 

Day: 4025047823 

METROPOLITAN UTILITIES MUDOl SANDY MUD Alt: DISTRICT 

Emerg: 4025047970 

Day: 4024447197 


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

Emerg: 4024445160 

Day: 4067289343 


OMAHA PUBLIC POWER ELM 0PPDGPR5 Alt: 4062071494 DISTRICT LOCATING 

Emerg: 8887289343 


dlion.org/irthinternet/.../MessageText.as... 1/2 
www.dhon.org/irthintemet/DHONNotic...^k 

• WDay : 4067289343 

QLNNEIC QWEST LOCAL NETWORK ScATING ^' - ^062071494 

Emerg: 8887289343 

on.org/irthinternet/.../Me5sageText.as... 
A As-Built Drawing A 

COASTA

ENVIOOHHEHTA

L 

L Omaha Lead Superfund SiItt e C R O U r . IM C 

OLS#: 29885 

Date Excavated: 4/5/2011 

Date USEPA Siqned Off: 4/21/2011 

ftrpa Snriripn- 11 ^«; .»q ft Hl2y./6 ^ Z^BBG" 

Name: Omaha Lead Site Date: Z'^-''^~'^' ^ Ncxth Arrow 

Addre: Site Sketch Time; i(-f f Ar> 

Ptione: yig.2 

r M MjyTb./eu. Team ^Ij^Ji-t^ /Pi ^ P^nr P BV1D# ^ /r/f S XRF Code ;03 7 gotfc'• 12.<» 

Sample Numtier Lead Concentration Confimiation Sample 

:2z ppm Yes E3 No O . 

:ze- ppm /QL Yes O No t3 ^ 5§5 ffl Yes Q No y ^ 581 ppm 

ppm •y.2- Yes CD No Q ^ 

ppm j>z-ye8 P Nu D 

ppm -Yes O - Nu P

ppm Yea D Nu • 

0 SL 

EJNTi^REJD 

! AUG \ 3 20$ 

j — Bl = 287 PPM m 4' B2 = 355 PPM ( 

EA = 85 PPM m 1 

Omaha Lead Site 46130 

Legend 

Concret.e Drip Zone Excavated Quadrants Excavated 

Area replaced with Area replaced with 


Area left bare 
 Sod Rock/Mulch 


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

« l22./e>^ Z'iBS^ 

' ^ 

Name North Anow ; 4*7 A Z.A /^.^^AAP^ Omaha Lead Site Date: ;;?-^.?-^^ 5 

Addres^: /Z-^ ^ //Ai/c> < y Site Slcetcii Time; _Uzp£.Aeir> 

Phone: -^^.2 '-y< ^ 7 - ^ ^ /

y 

Team RVID#^^^< > _ XRF Code 103-1 BonJ^ • 12.«? 

Sample Number Lead Concentration Confimnation Sample 

^ ^ ppm /•'/ Yes ^ No —y /

r z . Yes O No CB^ 

^ / Yes Q No ^ /ZHl>ScPXA'2.'^iB5 Sfl i PP"" -gg^ Yes CD No C9^ ??*?* ppm 

Nu P 

Omaha Lead Site 46130 
vV, 

<^^ ^ ZfS8 ^ 

% 

Name; Z-^ZA P y yi^^^Afr Omatia Lead Site Date: 7-y^'C^ 3 North Arrow —i 

Addres^: /y^/^Z- P/yP ' <P ' Site Slcetch Time: il-0 ^ AA^ 

Phone 

Team _ XRF Code 103 1 goo*^'• \i.<J 

Sampie Number Lead Concentration Confimnation Sample 

lL^A^cp7,fi, 'Z^38*P 3Z /^/ Yes cn No m ^ 

:m g - ppm /^<L Yes CD No 0 \ 

^ / Yes a No Q ^ /2Hl>SCP>cA'Z'^iSS ^ f l I PP"^ • ^ g ' ppm ^ ^ Yes O No £3"^ 

— I — ppm 

ppm ^es—B - Nu D 

_=__ _ ppm Nu • 

m 

T , I I X I E^NT^EEi] 

^^^ ^ y >^—4 i lAus|3 2af 

y \ \ : ; T ; .£_ t t _ t J t J 

J -i­ / . / 

^ A — j — •*­ -H - l ~ 

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150­

, _. 

^•=4i= 

r' f ^ 

hH^w*««•*«»* « >**»****»»»»y••»*»*»»•* * 

WAl ^ 

MAfii-H I 

AJOT ^ 

Omaha Lead Site 46130 
Name: j^^/t^y^ia/^x^ r 

Addresi^: /y.^/ . Piy>Z^ <•>-

Phone: y'tf:2-<//.7-^.<:£a/ 

Team 

Sample Number 

4 )2Ht>scpxA'£')iss 

5 -Zir 

6 

2 ^ 

^naha Lead Site 

Site Sitetch 

mizfof 

Date; ;^-^^-^ 5 

Time: //-tf^" AA>^ 

Zeiss' 

North Arrow 

$-Kftc-.- zj ( p«i+«-^-31-05* nmia^j-aii 

BVID#^^^< r _ XRF Code 103 1 Btmf/ii»2.«} 

Lead Concentration 

«^ - ppm 

r;^g~ PPf" 

^F J PP"* -2fii ­ ppm 

ppm 

ppm 

" ppm 

Confirmation Sample 

P ' Yes Cl 

/ ^ ^ Yes D 

<f/ Yes D 

•^ ^ Yes D 

^g—Yes P 

No ° 

No CB\. 

No 5 > 

No t3 ^ 

Nu D 

Nu D 

Nu • 

I AUG i 3 20^ 

jU>(^ iNtAFtg"! ^ 

w ^ 

^ 

r' F2, 

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HA? i i ^ 

Omaha Lead Site 46130 
COA S 1 i^ I 

[NVIItONn f KTA I 

c It 0 u r I h c 

Consent fof Acccisv To l''io|;a[-ty 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property' owner) consents to and authorizes the United States 

Environmental Protection Agency (EPA) oi its authorized representatives, collectively 

the Grantee, to enter and perform certain environmental response activities upon the 

follov/ing described premises: 

Ovi^ner's Name Daytime Phone: ' ' ' 

fp P A c?7f& K/ € I 111ZZ.IZ.. P-y^'ZZ 

Address of Property 

covered by this 

Agreement: \7)0'6 7^-^f e. y 

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) W\\\ 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 perfonned, 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 
C 0 A S V A i \ - z t K VIROHH^KIA t 

C N 0 U r > )^ C 

Remove obsiructions including boats, trailers, vehicles, playscape ilems, wood 

piles, dog houses, etc; 

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

to save; 

Water and maintain leplacemenl vegetation, including fertilizer application, as 

necessary' subsequent to an initial watering period by EPA; 

Abide by heaiih and safety guidance provided by EPA; 

If the property is rented, assist EPA in obtaining tenant approval fpi access lo 

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 (402) 991-1199 

grant access to my properties D I do not grant access to my properties 

Signature Date Signature Date 

Q I would like to be present during any sampling thsf is required. 

Page 2 of 2 
COASTA L CNVinONMENTA L 

CROUP . INC . 

Restoration Agreement 

The purpose of this 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 property owner and the United States Environmental 

Protection Agency (EPA). 

Property D): ^ f/'/'J " 

Property Address: PsF 

I Owner: Yj ^pzpppplp 

Plione: 7/i r.t^7 Z 7/f 7/y lyhcri y 

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 return of these items is the Owner's responsibility. 

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

Item: 

/y-7/ M/ ^ _ ^ 

i Item: 

^ 

Item: ^ ^ 

Item: ^ 

Page 1 of. 7 
C O A S T.A L • MVmOMH I MTAL e * o u p . INC . 

Items to Be Removed By Contractor During Remediation and Replaced 

Landscape Inventory 

Itern Quantity Unit Condition/Type/Species 

Pre-existing property area, 3', 02. Quadrants that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch Each 

trunk diameter y 

Number of trees <= 2 inch Each J0 trunk diameter 

Number of Sprinkler y

Zones, Control Valves, Each Timers, Heads, etc. 

Attach a sketch of the 

sprinkler layout. 

Number of and size of 

each garden/ flower bed Each 

area. Square Feet 

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 propert}' 

owner. 

Easement Area, to be 

excavated f f c^^y Each fpPdZy^j (Leyyll S 

Page 2 y 
COASTA L 

CROUP . IMC . 

Additional Comments / Instructions: 

The city of Omaha ordinances may prohibit 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 underlying a gravel or dirt area on your property that you may be 

using as a driveway or vehicle parking area. If this is the case, 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 withstanding 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 city of Omaha's Planning Department at (402) 444-5150. 

I~l Please check this box if you understand the information outlined above. 

J^Cf^.t z^^^ ^^-^^ 

• Check the box if Owner does not want CEG to document interior foundation walls and possible 

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

interior of house, including foundation cracks or fissures. 

gree not agree 

^/i6n7z[yi^ZA/iAtyjy z7^^-^<*^ 

er's Signature ' Date ' / Contractor's

s Signatur Signaturee 

Pages o. ^ 
BVID#2.^^« ^ 

XRF PROPERTY SAMPLE SHEET 

Date 

Project 

XRF ID# 

Shot# 

'H(^ 

HI 

t & 

Average 

Shot# 

5 0 

^ \ 

^V 

Average 

Shot# 

c,^ 

^S 

<^i^ 

Average

Shot# 

Average 

Signature, 

"i-fa-^ow Address 

Omaha Lead ARRA Sample time 

^'lot.-z. sample length 

Reading Sample area Shot# 

^ 1 1 O e^ 

^o^^\ ^ Depth 

l^- t VS i - ' 

S*b^\l^ Average 

Reading Sample area Shot# 

^ ^ ^ ^ 2.^ ^'J ^ 

^jv-?,^ n Depth 

3ni n y 

2e>l ^ Xu Average 

Reading Sample area Shot# 

3S\^-1 ^ ^± 

S^\S '^'J'^ Depth 

510^, "^"^ H" 

 "^^ ^ ' ^ ^ Average 

RETEST AREAS 

Reading Sample area Shot# 

Depth . - • • " " ' / 

y / 

Average 

VLJCJI ^ AA«.^p\<. 

am/pm 

30 sec 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Reading Sample area 

Depth 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 i^iddlesex Turnpike 

Billerica, r^A 01821 

XL3t-39022 

Reading No 

r^ode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRFTECH 

r^isc 

NOTE 

Supervised By 

Certificate of Verification 

49 

SOIL 

2011-04-06 19:21 

90.45 

Final 

Avg of 46-48 

1606 r^laple 

EA 

1" 

M. MATEUS 

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 92.420

Supervised By: 

Certificate of Verification 

46 

SOIL 

2011-04-06 19:19 

30.19 

Final 

29885 

1606 Maple 

EA 

1" 

M. MATEUS 

Confirmation 

CLEAR 

± Error 

± 17.061 
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 90.515 

Supervised By: 

Certificate of Verification 

47 

SOIL 

2011-04-06 19:20 

30.14 

Final 

29885 

1606 Maple 

EA 

1" 

M. MATEUS 

Confirmation 

CLEAR 

± Error 

± 16.607 
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 73.317 

Supervised By: 

Certificate of Verification 

48 

SOIL 

2011-04-06 19:21 

30.i2 

Final 

29885 

1606 Maple 

EA 

1" 

M. MATEUS 

Confirmation 

CLEAR 

± Error 

± 15.511 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 53 

Mode SOIL 

Time 2011-04-06 19:24 

Duration 90.71 

Sequence Final 

Flags 

AVERAGE Avg of 50-52 

ADDRESS 1606 Maple 

QUADRANT Bl 

DEPHT 4" 

XRF TECH M. MATEUS 

MISC Confirmation 

NOTE CLEAR 

Supervised By 
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 231.861 

Supervised By: 

Certificate of Verification 

50 

SOIL 

2011-04-06 19:22 

30.20 

Final 

29885 

1606 Maple 

Bl 

4" 

M. MATEUS 

Confirmation 

CLEAR 

± Error 

± 23.532 
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 313.908 

Supervised By: 

Certificate of Verification 

51 

SOIL 

2011-04-06 19:23 

30.24 

Final 

29885 

1606 Maple 

Bl 

4" 

M. MATEUS 

Confirmation 

CLEAR 

± Error 

± 27.866 
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 317.839 

Supervised By: 

Certificate of Verification 

52 

SOIL 

2011-04-06 19:24 

30.27 

Final 

29885 

1606 Maple 

Bl 

4" 

M. MATEUS 

Confirmation 

CLEAR 

Error 

± 27.338 
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 

57 

SOIL 

2011-04-06 19:27 

90.33 

Final 

Avg of 54-56 

1606 Maple 

B2 

4" 

M. MATEUS 

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 381.817 

Supervised By: 

Certificate of Verification 

54 

SOIL 

2011-04-06 19:25 

30.01 

Final 

29885 

1606 Maple 

B2 

4" 

M. MATEUS 

Confirmation 

CLEAR 

± Error 

± 29.849 
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 345.282 

Supervised By: 

Certificate of Verification 

55 

SOIL 

2011-04-06 19:26 

30.01 

Final 

29885 

1606 Maple 

B2 

4" 

M. MATEUS 

Confirmation 

CLEAR 

± Error 

± 29.313 
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 340.813 

Supervised By: 

Certificate of Verification 

56 

SOIL 

2011-04-06 19:27 

30.31 

Final 

29885 

1606 Maple 

B2 

4" 

M. MATEUS 

Confirmation 

CLEAR 

Error 

± 29.270 
i ^fO^ \ Omaha Lead Site—Fixed Price EP-R7-07-05 

I ^^^7 s Coastal Environmental Group inc. 

Sy^y^ www.coastalhazmat.com — ^^iPHO-(*^ COASTA L 

EHViaONHENTAL 

CIIOUP.IN C 

EXECUTIVE SUMMARY: 

BVID #29885-(1606 MAPLE ST) 

No Issues or Concerns \p\ Issues/Concerns 

Detail Explanation: . ._ . 

-DAN GARVEY WALKED THE PROPERTY ON 04/21/11 
Property Completion Agreement 

ihis agreemenl documenis llie complclion of remedial acliviiies perloimed on my properly. My signaiuie 

will designate ihai I am satisfied wilh lhe resloralion of my properly, and ihal no uems are in queslions, 

now, or al any lime in the fulure, except ihose ilems listed below, ifany 

PropcryfP: ^^^ 5 

Property Addrc.ss~%^ ^ ZT^ZMp ^ 

Owner: UpTZZa ^./I ff J-- / ) J. - .M. .. 

Q-""- hn-f-^^^^M- ,zQ.6.^z\.^^ 

Phone. q^cp^U(2.^:h I^Tfh^ 77^^ 97<Z^ 

Restoration Items in Question: 

j Item: 

Ilem: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

Jr J I aj;rcc ic.ttoralion is completed, except as noled 

[ ( I do not ajjrec resiorati'nn is completed 

y2i 
EPA Property Close Out Form 

Property #: ^^S ] Property Address: 

Date/Time Owner's Nanie:, li 

Quads Excavated*. Contraclor Croup 

Excavation General 

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

2. If necessary, were the correci areas ofdrip zone excavated and restored? 

GradInK Sod and VeRetstion 

I. Does the gredthg around the perimeter ofthe house in excavated areas generally slope away 

front the house? 

2. 

Has sod been laid in all areas that were excavated? 

i. 

Does the isod 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 thejoints 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 propeny? 

7. 

Was dainage to landscaping or plant materials avoided? 

Gates. Fences and Reuinlng Walb 

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

2. Were all gates or fences taken down during restoraiion activities reinsulled? (if applicable) 

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

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

FoundatioB, SidiDK and Goiters 

1. Was damage to the siding or trim avoided? 

2. Was damage to the foujidaiion avoided? 

3. Was damage lo windows avoided? 

4 Was damage to windows or door screens avoided? 

5. Was damage to downspouts or downspoul extensioiis avoided? 

Sidewalta and Driveways (Concrete) 

1. Was damage lo driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 

Yes No 

/ 

y 

Yes No 

/ 

y 

y 

z 

z 

z 

z 

Ves No 

z 

J 

J 

z 

Yes .No 

7 

7 

7 

7 

7 

Yia No 

^ 

/ 
owners comnients: 

I 

jlnspectiori no<es: 

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

EPA Represenlalive 9<x"-)^ Date; wU'l't