### CONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE US Army Corps of Engineers



### ECC Certification for Property Closeout

OLSID 32784 Property Address 3804 N 24 th 

### 8t Field Work Started 9/16/2007 Field Work Completed 9/17/2007 

### Summary: 

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

# • FI excavation depth was 8 inches below ground surfaces. 

# • B1 excavation depth was 5 inches below ground surfaces. 

# • F2 excavation depth was 8 inches below ground surfaces. 

# • Verification samples confinned 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

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### ECCQCM

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## -1- Name Title Date ature Jeff Hubbard USACE Con Rep 

# 10/35/ 07 

# rii1J..W Name Title Date I 

### SigIfia

# 32784 Name: Omaha Lead Site Date: NOrth Arrow Address: Site Sketch Time: Phone:

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Omaha Lead SitePage 1 of

_
Omaha Lead Site Omaha, NE U.S. Environmental Protection Agency Region 

### vn Residential Yard Soils Environmental Restoration Services I'I{( )]'1 I{ [Y \C CI."" (1,1 b<: (llll1)'kktl 11: I'll1!lL'II: (hllll'(') 1'.11;lll'llhll <:".11"1111.1**L'~P:\I'lllll'tll** 1;\\('1 ,1;II11L':d**[-~(JO-22.~-()-L:'** 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 activit' the following described premises. For further information please contact EPA at 1-800-223-0425. Property Access Granted By 

# 'S""- -ill\.**13-f£,1h~FCl-,** 

# 1 (Please PrinrName)

## ~-J./-07 (Date) NOTE: Granting permissi ply your property will be remediated at this time. )'I{U)'I R II 1,1 ()1{\lxr 10, (Ill**h~'** (tlll1l'kkcl h\ 1 <:,itk'111 .llld III 1'1 Up,'11: L1\II1,T I'k-.h<: 1'111111 Resident Name:**~Ci** 

### etv\'**P't6~** 

### vJ towner 

# o Renter Residence Address: 

# 3 GC( 

# 1'1. 

# d 

# i 0t1lAt/A= (CITY) (STATE) (ZIP) Property owned by, 

## 'Sll 

# Wt (}'I 

# Si2'iOwners mailing address: 

# 7 

# 5 U 

# I /l c: Owner's telephone number-Home: 

# f-{'S7- 

# 42.5] Work:

_ Age of Home?**....;t.....~~=-_t_"__** years How long have you lived here? years Has the exterior been painted or covered with siding since 1978 DYES 

## o NO Has the interior been painted or covered since 1978? DYES 

## o 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 Wlder this agreement are pursuant to Section 104 ofCERClA, 42 U.S.C. 9604. EPA's right ofaccess to the property for in Sectioo 100(e) ofCERClA, 42 U.S.C. 9604 (e), which provides entry for, "detennining 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:

_

### pg._of_ 

# List of Existing Conditions
Pro pe rty Add ress:

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Date: 15-':;> 1- 

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Description 

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## rr::er Signature ECC

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

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

# I Slr()1 ;J.ifsr**s~7JT1** Property Owner Is the Owner the Resident? DYes

### ~o 

## --;r' cJ

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### /Ylt'25 L£ t( 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 (BCC) to remove lead contaminated soil and provide subsequent restoration services. Your cooperation in giving EP AlUSACEIECC 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 Bahoke, EPA Project Manager, at (913) 551-7003 or the Office ofExtemal Programs at 1-800-223-0425. Additional Comments by 

### USACE and/or ECC:

CONTRACTOR CERTIFICATION Prashant Khanna or ECC Project Manager Charles "Skip"Milton Name Date Signature Title



## PROPERTY OWNER SECTION This agreement documents the completion of remedial/restoration efforts at the property to my satisfaction. 

# W- I agree that restoration is completed at my property, except as noted Comments (if applicable): 

# Ill/

-

# ~ff4**YJf&~** Property Owner's Signature 

# t:7 Date 

# / /) /% .- /P ?

## Property Owner Satisfaction Survey Form Omaha Lead Superfund Site Perfonnance-Oased Contracting (POC) Pilot Project
Remediation Contractor:

__**....Jj£~C=c..=-** 

# _ Property Identifier Number:

_ Property OVID Number: 

## c..S

# d-7 

# s- i Property Address: 

## 38'tJt{ II 

### /).,'1 

## s r Property Owner's Name: 

### -;S;OJfJ0 

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

## ••••••••••••••••••••••••••••••••• **** •••••••••• * ••••• * •••••••••••• 

## *.* ••••••••• Instructions to Property Owner: 

### This fonn 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. Army 

### Corps of Engineers (USACE) are very interested in your opinion regarding the work perfonned by our contractors. This fonn is intended to provide an easy means for you to express your opinion about the work perfonned on your property. Please indicate your level of satisfaction with the Contractor's work by 

### selecting a nwnerical rating (ranging from 1 to 10) using the following rating scale, then please sign & 

### date the fonn 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"

10 5 9 4 8 

### 3 7 2 

### 6 1 

### Additional Comments from Property Owner (optional; continue on back of page if needed)

Property Owner's Signature:

# dJb. .EI:C. 

### CONTRACT # 

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

# mJ

us Anny Corps

of Engineers 

# ."

Analytical Results Summary

Quadrant 

### DE Sample Type

F1 

## OLS#32784 3804 N 24 th 

## St

I Deptb I Date Collected 

## I 8 

## I DE 

# I F2 

## II 8 II 

### DE 

# I 81 

## II 5 

## II 9/14/2007 9/14/2007 9/14/2007 XRF Results (ppm) (avg.) 13 

# I 37 

# I 8 

# I 

# I I I 

# I

SAMPLE 10- SAMPLE ID is a particular residential property 10 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, Fl 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