TRANSMITTAL of OMAH A LEAD SITE 

SOIL REMEDIATIO N FILE FOLDER 

SAID#: 8^Sl ^ Date: /d-/3-od 

Address: /^3Q L /VJ 3 5 S T 

Remediation Contractor: Coastal Environmental Group_ Year: _2008_ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

) / Video of property (DVD) ^^^'"^ 

y T Executive Summary 

EPA-provided property sketch ' ^ '^^"^ ^ 

signed Access Agreement for subject property 

Signed Access Agreement(s) for adjacent propertyv/ • 

^ 

jy ^ Restoration Agreement , 

t~-f/n Settlement documents (i.e., for damage or to replace plants, etc.) /v^ ^ 

yS ^ Confirmation data - i 

y ' Photographs prg,-^.)(/-/gJgA6vN^ Q^JTryAhi^^ ts^Uki^C^ ^ ^0'^,^^^' ^ 

H ^ As-built sketch/l»4e>5. 

-H Satisfactory restoration signed by Property Owner 

J3 Property close-out check list signed by EPA 

kdl|f^ '^ Description ofareas not meeting ROD cleanup criteria 

-H-^ Utility clearances 

yy ^ Property information from Douglas County Assessor's Office 

D 't4^fy^^h^t 

Si^ature Dkte \ 

y^^^-'f^tici/yJ^A^'J' ^ <^^ ^ 
Property Access Checklist 

Property ID: S*^Si M 

D WORK STARTED ON: / / 

D WORKCOMPELTED ON: __/__/ _ Property .4ddrc.s.s: j^^g t M 3.'-^'^^ ^ 

Renter: """^:'^^IH^dette ^Wa^hLQQto 

Address: Phone: 

Fax: 

Cell/Pager: 

Additional Information: 

Fax: 

Ce "'^'''^«^'-- c9frQ-b3t.i 

1 1 Notification Letter Sent: / / By: 

^ T Acces.s Agreement Signed: 0 /1 ^ /2% ^y.pC 

P^Restoi'ation Agiecnient Signed: C? / l<\ / O ^ 

By.<cC 

1 1 Topsoil Sampling (if appliciibic) / / By: 

0 Dispo.sal Sam|)ling (if applicable) / / By: 

1 1 Garden Sampling (if applicable) / / By: 

IpSs litilitv Clearance Called: 6 /5^/OS B.v:^^7r^'? M 

1 n Video/Photos (Bcfoi-e) On: ^ /d^/d^ B.v: fih 

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

n Video/Photos (Aftci-) 

On: / / By: 

j D Video/Photos (3()-Day) On: / / By: 

1 1 Property Completion Agreement Signed: / / By: 

1 1 Final Report Is.sued: / / By: 

Air Monitoring (as applicahle) 

1 1 Community CH Ci'cw On: / / 1 

Results: j 

E] Community [U Crov On: / / By: 

Results: 

1 EH Community Q Crew On: / / By: 

Results: 

Omaha Lead Site 
CONTACT FORM 

Property ID # X^5'>' V 

Property 

Address: lQ33yyy3l^yr 

Initial Contact: Date: Time: Actioni 

Second Contact: Date: Time: Action; 

Final Contact: Date: Time: Actioni 

Final Action: Transmit to EPA D Other yAction: D 

Comment: 

Owner 

Comment (s): 

Site \i^ ^ ^\\^ p^^^ i^ 'v^ii f^j^lHtt ^ i Coordinator 

Comment (s): 
Douglas County Account Infomation Page 1 of 1 (^xaa 

Dougla s County , Nebrask a Propert y Recor d - R060824000 2 

Print Report 

Parcel Dimensions available @ scale 0-50 ft west of 144 St - Vie w 0,n Ma p Information is valid as of 2008-5-19 Treasurer's Tax Report 

New Feature ->->- • Auto Sales Search 

Owne r 

WASHINGTON HARRIETTE D 

3319 LAFAYETTE AVE 

OMAHA NE 68131-0000 

Propert y Informatio n 

Key Number: 0824 0002 06 

Account Type: Residential 

Parcel Number: 0608240002 

Parcel Address: 

Legal Description: BEMIS PARK LOT 1 BLOCK 6 S 46 FT 46X50 

Valu e Informatio n 

Land Improvement Total 

2008 $500.00 $0.00 $500.00 

2007 $500.00 $0.00 $500.00 

2006 $500.00 $0.00 $500.00 

2005 $500.00 $0.00 $500.00 

2004 $0.00 $0.00 $0.00 

2003 $0.00 $0.00 $0.00 

Sales Informatio n 

Sales Date: 2001-01-04 

Deed Type: Book: 2171 Page: 328 

Price: $100.00 

Grantor: 

Grantee: 

Valid/Invalid: Invalid 

Exclusion Reason: Invalid Sale 

Lan d Informatio n 

Acres SF Units Depth Width Vacant 

0.05 2300.0 1.0 50.0 46.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R06... 6/12/2008 
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89514 

# As-Built Drawing 

C OAST A L Omaha Lead Superfund Site INVmONMINTA L 

GROUP , t N C 

Omah Exterior Paint North Arrow a Lead Site 

Site Sketcti • Good

• Poor Sarvipling Address: 1032 N 33 ST l^f Not paint 

SampHe Numt)er Lead Sample Samples Collected 

i 

LAB Concentration Collecteji Firm 

R YASCPXA-89514 F1 ppm Date to - 3 0 -o- r 

RYBSCPXA-89514 F2 ppm n Time 3-00 

RYCSCPXA-89514 B1 / 2 8 ppm n Samples Analyzed RYDSCPXA-89514 B2 I Hq^ft ppm D 

r^DgOOrXA 00014 B 2 ppm D n XRF Unit: GiSH2 . Book: J* ^ ? 

r^C20GPXA-80S14 GZ ppm D D Date: I J • OS" -o 7 

ppm D n Time A ^ Lab RYASCPLA-89514 

Staff ; Result 188ppm Number of Samples •• / J r\%v/ i 

Legend: F1 = Front Left. F2 = Front Rigtit, B1 = Back Left, 82 = Back Right DZ = Drip Zone, GZ = Garden. PZ = Piay 

All quadrants are as viewed from the street, facing property 

ENTS^RE L 

NOV 0 2 1M1 OLS#: 89514 

Date Excavated:6/27/08 

Date OSEPA Signed Off:7/31/08 

Area Sodded 1090 sq ft 

Legend 

Drip Zone Excavated Quadrants Excavated
 Concrete 

Area replaced with Area replaced witJi 


Area left bare 
 Sod Rock/Mulch 


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

89514 

Omah Exterior Paint North Arrow a Lead Site 

Sit • Good e Sketch • Poor 

Sampling Address: 1032 N 33 ST [vf Not paint 

Sample Number Lead Sample Samples Collected U\B Concentration Collecte(J Firm: F M I^W- C C 

RYASCPXA-89514 Fl ppm 

Date: 10 ~ 3 0 ~o 7 

RYBSCPXA-89514 F2 ppm n Time: 3 • OO 

RYCSCPXA-89514 B1 / zs ppm D 

Samples Analyzed

RYDSCPXA-89514 B2 ppm D 

RDZOCrXA-09i314 BZ ppm D D XRF Unit: ^5*^ Z Book: |*^J? 

RGZOCnXA-8951-4 GZ ppm D D Date I ) -OS" -O l 

ppm • D Time „ Lab RYASCPLA-89514 An. 

Staff

i Result 188 ppm Number of Samples = I '-f j / ns\y 

Legend: Fl = Front Left, F2 • Front Right, 81 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

Rex ."^ Created: 9C5/2n07 OS 44:43 i^^^^y••:„:,..,,,
89514 

Omaha Exterior Paint NorthArrow Lead Site • Good Site Sketch • Poor 

Sannpling Address: 1032 N 33 ST fi i Not paint 

Sample Lead Sample 

Samples Collected Number LAB Concentration Collectwl Firm: F M I^W- C C 

RYASCPXA-89514 Fl 

ppm Date: ID - 3 0 -O T 

RYBSCPXA-89514 F2 

1 1 2 ppm D Time: 3 • OO 

RYCSCPXA-89514 Bl I 2 8 ppm D 

Samples Analyzed 

RYDSCPXA-89514 B2 ppm D 

RDZOCrXA-09G14 DZ ppm D D XRF Unit: Gt'iH Z Book: |^ ? 

nGZOCPXA-80514 GZ ppm D D Date: 1) ' CS '0~ l 

ppm D D Time: At i Lab RYASCPLA-89514 

Staff: l^SU / 

s Result 188 ppm

 Number of Samples = i '-lLegend: Fl = Front Left, F2 Front Right, 81 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

E;NT ER] 3D 

' M M 0 2 Z;0i 7 

foe. = ^ 

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N. S?> ^^ 1. Rev 5 Crc«cd: 9'2f:2(>a7 08 44 43 w<>i4roi;3 

y : HI- Mt > x*> w >»' ;••' -•or M ' i(»r w J«»r iter »• ' >ij' m ; iUi ;r«f * B' :D)).' y—7 Mar .oar .'«;T 
COASTA L CHVUOHfflNTAt 

C I O U r I (• 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: Hft^fiw^ m^mm Daytime Phone: 

Address of Property 

covered by this w ^ %^ ^. Agreement: 

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 vwDrk 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 
JUN-19-2008 13:44 

,1 II 

• Remove obstructions induding boats, trailers, vehicles, playscape iterns. 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 iniiial 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 vwork 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 queslions about ttiis program, please contact Coastal 

Environmental Group, at (712) 352-0188 

^ 

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

' ' Signalure A Date / ( Signajure Daii^ ' 

Q I v/ould like to be present during any sampling that is required. 

^ - d t^SESTO BO 6T un[­
Restoration Agreement 

The purpose ofthis agreement is to provide a mutual agreement as to conditions ofthe property prior to 

remediation activities. This will also serve as documentation for the purpose of assuring that restoration 

activities are completed to the satisfaction ofthe property owner and the United States Environmental 

Protection Agency (EPA). 

Property ID: yy,\l \ 

Property Address: |0'} 1 V4 ^^^^ ^ f 

Owner: t^^j^f e Wj^^Mm^TO^ 

Phone:(qpt^^^^( ^%^( ^ \t\^^ »-PZ^i 

On the attached diagram(s) indicate area(s) to excavated and depth of e.xcavation. location of all known 

utilities, subsurface features, surface 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 w ith an arrow indicating direction of view. 

Items To Be Remove d 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: 

vlf7i4:; 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 1 of j ^ 
COASTA L 

Items To Be Removed By Contractor During Remediation And Not Replaced 

(Use additional sheets as necessary) 

Page 2 of. 
COASTA L ENVinONnEKTA L 

Items To Be Removed By Contractor During Remediation And Replaced 

(Use additional sheets as necessary) 

Item: 

Item: 

Item: 

itQJ\ u _ ~y^ 

Item: / y 

i 

Item: y 

Item: 

Item: / 

/ 

Item: 

/ 

Item: 

/ , j 

Item: 

1 

Item: 

Item: 

/ 

/ 

/ 

• 

Item: 

/ 

Item: 

/ 

Item: 

/ 

/ 

;... 

C Pages of ^ 
COASTA L 

Landscape Inventory 

(Use additional sheets as necessary) 

1 Item Quantity Unit Condition/Type/Species 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 

trunk diameter 

Number of trees • = 2 inch 

irunk diameter 

Number of Sprini^ler 

Zones. Control Valves. 

1 Timers. Heads, eic. 

Anach a iNeicli o\ rhe 

ipriiikler !a\oui. 

Number of and size of 

each garden/ flower bed 

area. 

.•''•.u;Ui: ;•; skciCli 111 ;cia;i\!: 

~-i:'es :inJ locations. 

y*^ ciftv, y Square feet 

y Each 

y •: ; • ; 

j y Each 

Each 

'^ 

Each 

Square Feet 

^ , 

Page 4 o,_k 

1 
COASTA L 

Item Quantity Unit Condition/Type/Species 

Agreed upon value of 

plant materials not to be 

replaced bv contractor. 

Note this value will be 

used fo issue a plant 

>oucher to the property 

owner. 

j K 

$ 

Agreed upon list of plant 

materials that will be 

replaced by contractor. Be 

very specific and detailed. 

Include a sketch of were 

each plant will he placed 

by [he comracici'. 

r Each 

Agreed upon area of 

property to be replaced 

with grass sod. 

Mu'lude a sketch oi' ihc 

area(s) u-. be repiaced ^^ith 

iii-as.s >,od. 

r SF 

.Area of City or County' 

property to be landscaped 

per their requirements. 

1 

SF 

Include

a:-eu iS) 

 -'i -keiv-fi ^.;' :'r.i 

i 

1 ' 

Easement Area, to be 

excavated SF 

.1 • 

. -1 

Page 5 of. 
L 

JUN-19-2008 13:44 P.03 

Additional Comments / Instriictions: 

^ HT^ 

• 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. 

Q I do not sgree agree 

>^/jMuj..y~^ y u i4rM y^,x uictpx 

Owner's Signature U Date / Contractor's Signaeure / Dat4 ^ 

Page 6 of, 

OI^S:T O 80 e t iJnr 

TOTAL P.03 

DI -d 
.a«;';#5i«**"'^^ 

FACSIMILE TRANSMITTAL SHEET 

TO 

FROM: 

COMPANY IMPAMV-

^ nATF - : 

Coastal Environmental Group ^b-l^-Q ^ 

FAX NUMBER: 

TOTAL NO. OF PAGES INCLUDING COVER: 

(Mtfa-^^\-aint,-^ 

SLTRGENT n FOR REVIEW n PLEASE COMMENT D PLEASE PAY n PLEASE RECYCLE 

NOTEJ,"".OMMENT5­

- If yoo Vuve any cioesticn 

P icas4. call me © 

-Mo\e' ^na-iV\\nQ over 405 ppm 

^Dv o \s eAa\n and udnl 
JUN-19-2008 13:44 P.0 1 

\]0e d States District C^ t 

DISTRICT OF NEBRASKA 

PROBATION OFHCE 

JAMES P. ROWOLDT 

CHIEK PROBATION OFHCER 

MARY LEE RANHEIM 

DEPirrV CHIKK PROBATION Of KICER 

111 SOUTH 18* PLAZA,SUITE C79 

OMAHA, N£ 68102-1312 

COMM (402) 661-7555 

FAX (402) 661-7550 

FAX COVER SHEET 

To: Marcos 

Phone/Fax: (402)991-2067 

From: Harriette Washington 

Date: June 19, 2008 (2:01pm) 

Subject: Agreement 

No. of pages including this one: 3 

Note: This Facsimile transmission (and/or the docuinents accompanying it) may contain confidential 

infonnation belonging to the sender which is protected by Federal law and local Federal Court policy. 

This infonnation is intended only for the use of the individual or entity named above. If you are not 

the intended recipient, you are hereby notified that any disclosure, copying, distribution or the taking 

of any action in reliance on rhe contents of this infonnation is strictly prohibited. If you have 

received this transmission in error, please notify us by telephone listed at)0ve to arrange for retum 

ofthe documents. 
BVID ^my XRF PROPERTY SAMPLE SHEET 


Date Address iA3a ^i . j?,-^ 

Project Omaha lead FP 22nn d year option Sample time am/pm 

XRF 1D# 32.<^ ^ sample length 30 sec 

Shot# Reading Sample area Shot# Reading Sample area 

us: uT ^ IC^T^" &;i 

Depth Depth 

^yu. 1/^/^/3 J ^ 

Average \^^' ^ tj y Average 

Shot# Reading Sample area Shot# Reading Sample area 

is^t- y 

IS-QL ? 

O 6 ^

I37 T

 I S 

 15 ec».jewv«rtV 

1 

\T-^ ^ I S3. ± / S Depth Depth 

/r3 Q 17^ t \C \ " 

Average / 5* / ^ I T Average 

Shot # Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

RETEST AREAS 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

lab sample # Lab result Sample area XRF Avg. 

Signature 

Print ftiflm b^r'cj n . 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpil<e 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 317 

Mode SOIL 

Time 2008-06-27 16:26 

Duration 145.37 

Sequence Final 

Flags 

AVERAGE I Avg of 313-316 ^ 

ADDRESS 1032 n 33 

QUAD/ZONE |6 2 

INSPECTOR I DETRICH 

DEPTH E6 

SAMPLE PI'PE 

NOTE 

..--" 7 

ppm / 

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 317.011 

Supervised By: 

Certificate of Verification 

313 

SOIL 

2008-06-27 16:22 

30.08 

Final 

89514 

1032 n 33 

B2 

DETRICH 

6 

± Error 

± 21.819 
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 115.181 

Supervised By: 

Certificate of Verification 

314 

SOIL 

2008-06-27 16:24 

30.29 

Final 

89514 

1032 n 33 

B2 

DETRICH 

6 

± Error 

± 14.664 
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 75.345 

Supervised By: 

Certificate of Verification 

315 

SOIL 

2008-06-27 16:24 

30.05 

Final 

89514 

1032 n 33 

B2 

DETRICH 

6 

± Error 

± 11.774 
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 114.129 

Supervised By: 

Certificate of Verification 

316 

SOIL 

2008-06-27 16:26 

54.95 

Final 

89514 

1032 n 33 

B2 

DETRICH 

6 

± Error 

± 13.442 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

Pb 

Supervised By: 

Certificate of Verification 

1531 

SOIL 

2008-07-30 19:30 

120.78 

Final 

I Avg of 1527-1530 

1032 N 33 st ~TM " 

easement 

*1opez ^ 

P 

^CLEARANCE 
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 136.204 

Supervised By: 

Certificate of Verification 

1527 

SOIL 

2008-07-30 19:27 

30.31 

Final 

89514 

1032 N 33 st 

easement 

lopez 

1 

CLEARANCE 

± Error 

± 14.606 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 1528 

Mode SOIL 

Time 2008-07-30 19:28 

Duration 30.07 

Sequence Final 

Flags 

BVID # 89514 

ADDRESS 1032 N 33 st 

QUAD/ZONE easement 

INSPECTOR lopez 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 137.373 ± 14.810 

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 152.294 

Supervised By: 

Certificate of Verification 

1529 

SOIL 

2008-07-30 19:29 

30.12 

Final 

89514 

1032 N 33 st 

easement 

lopez 

1 

CLEARANCE 

± Error 

± 15.340 
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 176.195 

Supervised By: 

Certificate of Verification 

1530 

SOIL 

2008-07-30 19:30 

30.28 

Final 

89514 

1032 N 33 st 

easement 

lopez 

1 

CLEARANCE 

± Error 

± 16.108 
X 

Omaha Lead Site—Fixed Price EP-R7-07-05 

Coastal Environmental Group Inc. 

\ www.coastalhazmat.com 

v-^^o'"* COASTA L 

ENVrRONHENTAL 

C I O U P . IN C 

EXECUTIVE SUMMARY: 

rd BVID # 89514 - (1032 N 33TM St.) 

No Issues or Concerns I I Issues/Concerns 

Detail Explanation 
Property Completion Agreement 

This agreement documents the completion of remedial activities performed on my property. My signature 

will designate that 1 am satisfied with the restoration of my property, and that no items are in questions, 

now, or at any time in the fiiture, except those items listed below, ifany. 

Property ID: ^^Cj^/l ^ iioptiiyiu ; WH^/ H 

Property Address: Ir\ nn , j J SQ^ ^ ^ T 

Owner: /^^rr/t ^ /JO^^W^t n 

Phnnp- / I-A /.I 1 —, « —^ '-J Phone:Lio^:(ff^/~1^3, ^ 

Restoratfon Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: , 

j 

I I I iigrci- ies(oration is compleied, except as noted 

I I I <lo not ajjrce resloration is completed 

Owner's Sigiiariire /Contractor's Signature Date 
Siii. EPA 

EPA Property Close Out Form 

yvi^yyyf 

Property #: Q^^l ^ . , 

Date/Time: 

Quads Excavated: |^7^ Contractor Croup f^Af^'P^'t 

Excavation Yes No General \/ACAl ^ Lo T 

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

2. If necessary, were the correct areas ofdrip zone excavated and resiored? y 

Grading Sod and Vegetation Ves No 

1 Does the grading around the perimeter ofthe house in excavated areas generally slope away 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 .10 

day time period) y 

4. Are sodded areas generally firm and evenly graded? y 

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

time period) y 

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

7. Was damage to landscaping or plant materials avoided? y 1 

Gates. Fences and Retaining Walls 

Yes No 

1. Do gates open and close freely? (ifapplicable) 

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

pA­ 3.

 Was damage to gates or fences avoided? (Ifapplicable) 4 ^

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

Foupdation, Siding and Gutters 

Yes .No 1 • — ' " 

1. Was damage to the siding or trim avoided? 

1 

2. Was damage to the foundation avoided? r- ^ \ 

1 . ( y 

3. Was damage to windows avoided? fJA 

LDA 4.

 Was damage to windows or door screens avoided? I 

5. Was damage to downspouts or downspout extensions avoided? 

-W . 

Sidewalks and Driveways (Concrete) 

Yes No 

1. Was damage lo driveway surfaces avoided? A ^ 

2. Was damage to walkway surfaces avoided? 

1 1 
Owners comments: 

Inspection notes: 

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

EPA Representalive^^;;^^^,^ ^ Date: 7/3//OS