TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID# ^^^ U Date: ^|l|| l 

Address: "^ \t ^ M Hf^ "/( 

Remediation Contractor: Coastal Environmental Group_ Year: _2010ARRA_ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

t/ Video of property (DVD) 

Executive Summary 

J EPA-provided property sketch 

Signed Access Agreement for subject property 

-LL Signed Access Agreement(s) for adjacent property 

U Restoration Agreement 

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

-P- Confirmation data 

a/ Photographs \\ i b^^l^V ^ X ^i^^V^lv^ ^ h ^ 

It/ As-built sketch 

Satisfactory restoration signed by Property Ow^ner 

Property close-out check list signed by EPA 

-fi" Description ofareas not meeting ROD cleanup criteria 

(M Utility clearances 

y Property information from Douglas County Assessor's Office 

• 

a 

/> "^yy^ 

Ignature Date 

30218495 

Superfund 
# # 

Property Access Checklist 

PropertylD: ^S D ( p (P 

Property Address ^/-^^^^ ^ 

n

n

 WORK STARTED

 WORKCOMPELTED

 ON:

 ON:

 /

 /

 / 

/ 

^'^^'Y^jy<4^>-,<^ AUy\A^^ 

Addren:' ' O 

Phone: Cff^f^f^^Z: ^ 

Fax: 

Cell/Pagen 

Rcnten 

Pbone: 

Fax: 

Cdl/Pager: 

Additionai Iirforniation: 

D Notification Letter 

^ Access Agreement 

Cp. Restoration Agreement 

EJ Topsoil Sampling (if applicable) 

D Disposal Sampling (if applicable) 

D Garden SampUng (if applicable) 

S L Utility Clearance 

, 0 video/Photos (Before) 

Q Video/Pbotos (Dnring) 

O Video/Photos (After) 

D Video/Photos (30-Day) 

D Property Completion Agreemeat 

D Final Report 

Sent: / / 

Signed: J^// ^ ^4 . 

Signed: j ^ / / ^ ^ 

/ / 

/ / 

/ / 

Caned:Jt_/ZiJL/fl3 

OmMlJFiA^ 

On: / / 

On: / / 

On: / / 

Siened: / / 

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By: 

By: 

By: 

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By: 

By: , . 

By: /M M 

^r-OcMi/iz:)' 

By: 

By: 

By: 

By: 

By: 

1 

Air Monitorine fas aonlicable) 

D Community DCm r 

Results: 

On: / / By: 1 

D Community DCre w | On: / _ / By: 

Results: 

D Community QCrcw On: / / By: 

Results: 

Omaha Lead Site 
Douglas County Account Infot]M|io >t|M|lC n Page 1 of3 

Douglas County, Nebraska Property Record - R2414890000 

Print Reoort 

NEW Faaturs - PaitMl Drmnnsions available l§ scale 0-50 ft west of 52nd St - Vie W OR Ma p Information is valid as of 2009-10-15 Treasurer's Tax Report 

New Feature •*•*• * Auto Sales Search | 

Owner 

MONEY KRISTAN E 

ETAL 

3129 N 48 ST 

OMAHA NE 68104-0000 

Property Informatio n 

Key Number: 1489 0000 24 

Account Type: Residential 

Parcel Number: 2414890000 

Parcel Address: 3129 N 48 ST 

OMAHA NE 68104-0000 

Legal Description: WAVERLY PARK LOT 23 BLOCK 3 40 X 123.3 

Value Informatio n 

Land Improvement Total 

2009 $5,700.00 $63,200.00 $68,900.00 

2008 $5,700.00 $67,100.00 $72,800.00 

2007 $5,700.00 $67,100.00 $72,800.00 

2006 $5,700.00 $67,100.00 $72,800.00 

2005 $5,700.00 $39,600.00 $45,300.00 

2004 $5,700.00 $36,000.00 $41,700.00 

Sales Informatio n 

Sales Date: 2007-06-29 

Deed Type: WD Book: 2007 Page: 074771 

Price: $75,000.00 

Grantor: KEITGES MARGARET J ETAL 

Grantee: MONEY KRISTAN E ETAL 

Valid/Invalid: Valid 

Exclusion Reason: 

Sales Date: 2007-06-26 

Deed Type: WD Book: 2007 Page: 099259 

Price: $0.00 

Grantor: Keitges Margaret J etal 

1 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accoiintno=R2... 10/23/2009 
Douglas County Account Infornagio rc^^ c n Page 2 of 3

Grantee:

Valid/Invalid: 

 Money Kristan E etal 

Invalid 

Exclusion Reason: Corrective Deed 

Lan d Informatio n 

Acres 

0.11 

Improvemen t

Building 1 

SF 

4920.0 

 Informatio n 

Units 

1.0 

Depth 

123.0 

Width 

40.0 

Vacant 

No 

11C STORY 3129 N 48 ST 

Second Floor »»6 0 oq. ft 

Flr« Flow 

894.0 sq. It. j t 9 

f7n 

^r 1 (inr KD 

«n 

iirr 4ir\ IDC 

BMMBtMdlll 

W2.0 l« n 

CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IMAGE 

Square Footage: 1340.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

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

HVAC: Central Air to Air Rooms: 5.0 

Exterior: Frame Aluminum Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 2.0 

Roof Type: [ Gable Stories: I 1.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: ! 0.0 

year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1921 0 0% 1921 89 

Detail Type Detail Description Units 

Add On Fence Chain Link 960.0 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 882.0 

Fixture Base Fixtures 1.0 

http://douglasne.mapping-onHne.com/DouglasCoNe/static/accountinfo.jsp?accountno=R2... 10/23/2009 
• Douglas Cotmty Account Infona^on rm^c Page 3 of3 

Fixture Bath Full 1.0 

Porch EncI Screen 96.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accoimtinfo.jsp?accountno=R2„. 10/23/2009 
Page 1 of2 

% 

"> 

[r . j^ ^ j [r^_^Back-talrth Interjiet J i[; Send Email ] 

• YOUR TICKET NUMBER IS 2404482. 


Original Call Date: 11/10/09 Time: 7:36 pm Op: ELIZABETH18790 


Work to Begin Date: 11/16/09 Time: 7:15 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 4817 Street: DAVENPORT ST 


Twp: 15N Rng: 13E Sect-Qtr: 19-NE,20-NW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: lead remediation 


Location of Work: INCLUDE ALL EASEMENTS LOCATE ENTIRE PROPERTY 


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


: tJNSURE OF CORNER LOT 


Company : COASTAL ENVIRONMENTAL SERVICE 


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


Work Being Done For: Coastal Environmental Group 


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


Involves Tunneling or Horizontal Boring : N Explosives: N 


BSHPCLKS CXCATV MUDOl OMAHACOF OPPDGPRS QLNNEIC 


Service Area Contact Phone Number UtiUty Type 

BSHPCLKS NEBRASKA HEALTH SYSTEM NA 

Day: 4025523460 

Alt: 4025523347 

Emerg: 4025595111 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RIcnmiAFFIC

Day: 4024447197 

 Alt: 4024445161 

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 11/10/2009 
Page 2 of2 

OPPDGPRS OMAHA PUBLIC POWER DISTRICT NA 

QLNNEl C QWEST LOCAL NETWORK NA 

% 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

http://wrvm.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 11/10/2009 
As-Built Drawing 

COASTA L Omaha Lead Superfund Site 

OLS#: 85066 

Date Excavated: 11/25/2009 

Date USEPA Sianed Off: 4/15| 85066 Area Sodden: 1575 sa fl 

Omah Extefior Pamt a Lead Site 

Sit • Good e Sketch • Poor 

Sampling Address: 3129 N 49 ST g Not pamt 

Sample Number Lead Sampte Samples Collected LAB Concentration Coitected Firm 

RYASCPXA-85066 Fl ppm of D Oate: ^wo & 

RYBSCPXA-85066 F2 ppm D Time: i-io !>•«»• RYCSCPXA-85066 Bl ppm D Samples Analyzed RYDSCPXA-85066 B2 ppm I n

RDZSCPXA.85066 DZ ppm n XRF Unit: (a^H D Book: 71.1-, 

nGgCCrXA-85066 62 ppm D D Date JQ -^ 0 -Q g 

nPJOCPXA OSOGC PS 

E 

ppm D D Time flno 

Staff: m<>L D Number of Samples = 

Legend: Fl = Front Left, F2 = Fremt Right. Bl = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Pla« 

AlquKliaiil»ir»aBjipw»idf>raniJ^a«lrMI. ticfcig propeity 

lUvJXB rieaktl ;7..\U64« 

Legen d 

Concrete m Drip Zone Excavated Quadrants Excavated 

Area replaced with Area replaced with 

Sod Rock/Mulch Area lef t bare 

Contrac t #: EP-R7-07-05 Coasta l Environmenta l Group Inc . 
85066 

^j^ life 

i>\y N y 5+ 

Omah Exterior Paint a Lead Site 

• Good Site Sl<etch 

• Poor 

Sampling Address: 3129 N 43 ST 0 Not paint 

Sample Lead Sample 

Samples Collected Number LAB Concenlralion Collected 

RYASCPXA-85066 Fl /5.5 . ppm D Date: q-1*1-Oft 

RYBSCPXA-85066 F2 

US ppm D Time: I •10 p.lfi-

RYCSCPXA-8S066 B l 14 I S nnm 

D Samples Analyzed RYDSCPXA-85066 B2 SS 9 ^ ppm I D 

ROzscPXA-asoee oz 13 oq ppm D XRF Unit: fa^HO Book: Z2f t 

nCZSGrXA-86066 S2 ppm D D Date: /Q -30 -OS 

nPgOCPXA-fl5066 P2 

ppm D D 

Time flm 

Staff f^-JLJ Numtier of Samples = | ^ \ | Q | 

Legend: F1 = Front Left, F2 : Front Right, Bl = Back Left, 82 = Back Right DZ = Drip Zone, GZ = Garden, PZ - Pla; 

All quadrants are as yifwed fnyn J{ie streei. facing properly 

1^^^,.,,,,: , 

5^ 

15 

-y 
\JU li^^« # 

85066 

Omah Exterior Paint a Lea d Site 

• Good Site Sketc h 

• Poor 

Sampling Address: 3129 N 43 ST [ 3 Not paint 

Sample Lead Sample Samples Collected Number LAB Concentration Collected Firm -EDO Pg.ffT 

RYASCPXA-85066 Fl ppm D Date q-^'^-oR 

RYBSCPXA-85066 F2 ppm 155 Bf D Time i-'o p-«ft- RYCSCPXA-85066 81 ppm D Samples Analyzed RYDSCPXA-85066 B2 ppm D 

RDZSCPXA-85066 DZ ppm I D 

XRF Unit: fo^H O Book: ZZ£1 . 5?°l RCZSGPXA 85066 -S 2 ppm D Date: _ 

nPZOCPXA-0S066 PS ppm D Time: _ 

f^m 

Staff: Number of Samples = | ^

n \ \ f ) | r?5u> 

Legend: F1 = Front Left, F2 = Front Right. B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden. P2 = Plai 

All quadrants are as ytawed frtimj{»e street, facing property 

4Wf^,..,-„:, 
85066 

Omah Exterior Paint NorthArrow a Lead Site 

Sit • Good e SIcetch • Poor 

Sampling Address: 3129N_48ST_ Q Not paint 

Sample Number 

RYASCPXA-85066

RYBSCPXA-85066

RYCSCPXA-85066

RYDSCPXA-8506e

RDZSCPXA-85066

nOZOOPXA 86066

RPZOCPXA-OOOOO

 Fl 

 F2 

 Bl 

 B2 

Lead 

Concentration 

i3g 

ppm 

ppm 

ppm 

ppm 

Sample 

Collected 

of 

LAB 

D 

D 

D 

D 

Samples Collected 

Firm:_£Ofi Pg./tf 

Date: qW-Oft 

Time: I'tO p-«n. 

Samples Analyzed 

 DZ ppm n XRF Unit: i^Sf ^ Book: 22^2 . 02 ppm D D Date: _ 

 P2 ppm D D Time: _ Mm 

Numtier of Samples = | $ \ \ Q | Staff: -GQ£L2-

Legend: F1 = Front Left, F2 = Front Right, Bl = Back Lefl, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Pla; 

intsarea »:^«wed ing property 

( 1 :

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OCT 29 2M

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 i 
COASTA L INVIROHHIKTA l 

c R o b r IN 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: 

Address of Property 

covered by this '^\v? AJ 43^~^ 

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 worl( 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 

iiemain in effect until the work has been satisfactorily completed. The Grantor also 

agrees to: 

Page 1 of 2 
COASTA L tNVINONH^KTA t 

CROU P IM C 

« Remove obstructions including boats, trailers, vehicles, playscape items, wood 

piles, dog houses, etc; 

c 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; 

c 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. 

<i 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 worit 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 

& \ g grant access to my properties 

D I do not grant access to my properties 

Signature 

Date 

D I would like to be present during any sampling that is required. 

Page 2 of2 
COASTA L 

Restoratson Agreemertt 

The purpose of this agreement is tc 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 of the property owner and the United States Environmental 

Protection Agency (EPA). 

Pn-p^lylD: gj- ^ ^ ^ 

Property Addrea: '^)2f ^ /KJ 4-^"^ ^ 

Owner; j y ^/^A ^ ^ ^ Ql^ Y 

5!E22ZISLS 

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

"^"l-T/? 

Kem: 

Item: 

Items to be Removed by the Contractor During Remediation and Wot Rep|aced_ 

Item: 

Item: 

Item: 

Item: 

Pagel of. 

1 
COASTA L 

items to Be Removed By Contractor During Remediation and Repiaced 

Item: SQ/^-B/ ^ )?^^ 0 

Item: 

5D/D - y / , /?:? 

Kem: 

Item: 

Landscape Inventory 

Item Quantity Unit Condition/Type/Species 

Pre-existing property area, Quadrants that will be excavated, that 

is covered with grass. 

g2 

Number of trees > 2 inch 1 Each 

trunk diameter 

Number of trees <= 2 inch Each 

trunk diameter 1

Number of Sprinkler 

Zones. Control Valves, 

Each Timers, Heads, etc. 

Aiiath ;i skcicli ul \\M' 

•.rr'fklci IHV'.HI; 

Number of and size of 

each garden/ flower bed Bach 

area. Square Feet 

Atlitth il skcicli ol rL-!;iIiVL' 

^1/fS niid loc;iiioii.s 

/

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

S 

VCK' Ihi' Millie Mill tit 

liSCf 10 IS'.Ul .1 plHii ; 

^Olll•;lt•: ll/ ilif |;.-i!|)Crl> 

U" ner. 

Rasement Area, to be Each 

excavated M 'f^J^y l^65c/r 

Page 2 of, 
C O A S 1 A L I M vin o M n • MTJk. C ^ O U I. , IN C 

; AddKional Comments / Instructions: 

Q 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 notresponsible for any damage done to the 

interior of house, inciuding foundation cracks or fissures. 

[3 ^ agree CD I do not agree 

yyisiy/fl&^^'^ U-l^d^ 0 [<^y^ ^ ,jMfA 

/Owner's Signature \Date K:t^racfBi>>$Signfltnrr Date ' / / 
Coastal Environmental Group was awarded a contract from the EPA to remove Lead impacted soil from residential properties within the Omaha Area. 

Per this contract Sunday work activities can only be performed with written consent of the neighboring residents. By signing this form 1 acknowledge 

that 1 understand that excavation and backfill work will be performed at the adjoining address listed on Sunday December 6,2009. 

Address Property Owner Signature 

5/:^7 K>He^r: K^tH^TAk) l^O^ V ^/^Mf^y/J ^ (}fA. ^i€>% K) ^*5^ . pS-fr^jy^ ZfJuu6:Z^JZ "^y^^/C^jbh^yu y ^ 

«,i29 K)H^^t. c-r — i ^ 
BVID# 2SDCoC. XRF PROPERTY SAMPLE SHEET 

Date l(-Z^-n') Address 

Project Omaha Lead ARRA Sample time 

XRF ID# sample length 

Shot# Reading Sample area Shot# 

t/y Z^:^ ^ 1&. M . 

yi zx^ft i^/"^ Depth JiL 

ik. /JiO^^v^ Jl! M2^ 

Average Hy> ^ J ^ )' ^ V Average

Shot# Reading Sample area Shot# 

^ f i^^D ^ J ^ iz. Zip ^l o Depth Jii. 21. JSg. to ^ ^ k!L 2^ 

y

Average (^*f >• \ 0 Average

Shot# Reading Sample area Shot# 

Depth 

Average Average 

RETEST AREAS 

Shot# Reading Sample area Shot# 

^^^ ^ Depth 

/ / 

Average Average 

Signature, 

Print ' 11/1-At^ WAU ^ 

3/2.-7 A/c/is r 

am/pm 

30 sec 

Reading Sample area 

h'^ ^f ^ SiZ^ 

Depth ( i ^ ^t ^ 

^ ^ i=^i( JjilL 

y

 ^3^ i VX, 

Reading Sample area 

f((f f i r C ^ 

/^^ i / ^ Depth 

tJHL H. / / f) Z- f S ' / 

Reading Sample area 

Depth 

Reading Sample area 

Depth 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certlfic 

XL3t-39022 

Reading No 47 

Mode SOIL 

Time 2009-11-25 17:30 

Duration 92.05 

Sequence Final 

Flags • ' " ") AVERAGE r rA^_Qt44-4&' 

ADDRESS "^12 9 n 48 st 

QUADRANT DZ 

DEPHT 13" 

XRF TECH R. VENTRY 

MISC ciearence 

NOTE ngnc 

ppm Error 

Pb 

Supervised By •.FfCAJ!!£M 
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 TEC H 

MISC 

NOTE 

ppm 

Pb 19.264 

Supervised By: 

Certificate of Verification 

44 

SOIL 

2009-11-25 17:28 

31.01 

Final 

85066 

3129 n 48 st 

DZ 

13" 

R. VENTRY 

ciearence 

ngnc 

± Error 

± 9.324 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 45 

Mode SOIL 

Time 2009-11-25 17:29 

Duration 30.54 

Sequence Final 

Flags 

BVID 85066 

ADDRESS 3129 n 48 st 

QUADRANT DZ 

DEPHT 13" 

XRF TECH R. VENTRY 

MISC ciearence 

NOTE ngnc 

ppm Error 

Pb < LOD 12.514 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 46 

Mode SOIL 

Time 2009-11-25 17:30 

Duration 30.50 

Sequence Final 

Flags 

BVID 85066 

ADDRESS 3129 n 48 st 

QUADRANT DZ 

DEPHT 13" 

XRF TECH R. VENTRY 

MISC ciearence 

NOTE ngnc 

ppm Error 

Pb < LOD 13.037 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 43 

Mode SOIL 

Time 2009-11-25 17:27 

Duration 92.39 

Sequence Final 

Flags 

AVERAGE (AvgjtSl42 

ADDRESS 3129 n 48 st 

QUADRANT B2 

DEPHT 6" 

XRF TECH R. VENTRY 

MISC ciearence 

NOTE ngnc 

ppm Error 

Pb 157.505-^ 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 40 

Mode SOIL 

Time 2009-11-25 17:26 

Duration 30.82 

Sequence Final 

Flags 

BVID 85066 

ADDRESS 3129 n 48 st 

QUADRANT B2 

DEPHT 6" 

XRF TECH R. VENTRY 

MISC ciearence 

NOTE ngnc 

ppm ± Error 

Pb 64.402 ± 12.348 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 41 

Mode SOIL 

Time 2009-11-25 17:27 

Duration 31.17 

Sequence Final 

Flags 

BVID 85066 

ADDRESS 3129 n 48 st 

QUADRANT B2 

DEPHT 6" 

XRF TECH R. VENTRY 

MISC ciearence 

NOTE ngnc 

ppm Error 

Pb 64.823 ± 12.157 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 42 

Mode SOIL 

Time 2009-11-25 17:27 

Duration 30.40 

Sequence Final 

Flags 

BVID 85066 

ADDRESS 3129 n 48 st 

QUADRANT B2 

DEPHT 6" 

XRF TECH R. VENTRY 

MISC ciearence 

NOTE ngnc 

ppm ± Error 

Pb 43.288 ± 11.157 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certlfic 

XL3t-39022 

Reading No 39 

Mode SOIL 

Time 2009-11-25 17:25 

Duration 92.10 

Sequence Final 

Flags 

AVERAGE PAvTof 36-38-1 

ADDRESS ^IT 9 n 48 st 

QUADRANT Bl 

DEPHT 6" 

XRF TECH R. VENTRY 

MISC ciearence 

NOTE ngnc 

Error ppm 

Pb 

supervised By: ^0fD}lj2 \ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 36 

Mode SOIL 

Time 2009-11-25 17:24 

Duration 30.96 

Sequence Final 

Flags 

BVID 85066 

ADDRESS 3129 n 48 st 

QUADRANT Bl 

DEPHT 6" 

XRF TECH R. VENTRY 

MISC ciearence 

NOTE ngnc 

ppm ± Error 

Pb 26.843 ± 9.807 

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 26.160 

Supervised By: 

Certificate of Verification 

37 

SOIL 

2009-11-25 17:25 

30.50 

Final 

85066 

3129 n 48 st 

Bl 

6" 

R. VENTRY 

ciearence 

ngnc 

± Error 

± 9.859 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 38 

Mode SOIL 

Time 2009-11-25 17:25 

Duration 30.64 

Sequence Final 

Flags 

BVID 85066 

ADDRESS 3129 n 48 st 

QUADRANT Bl 

DEPHT 6" 

XRF TECH R. VENTRY 

MISC ciearence 

NOTE ngnc 

ppm Error 

Pb 19.858 ± 9.356 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 35 

Mode SOIL 

Time 2009-11-25 17:23 

Duration 91.59 

Sequence Final 

Flags 

AVERAGE £Avg of 32-3£ 7 

ADDRESS 3129 n 48 st 

QUADRANT em 

DEPHT 1" 

XRF TECH R. VENTRY 

MISC ciearence 

NOTE ngnc 

ppm Error 

Pb (yixQ.\n'Cy ± 

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 116.291 

Supervised By: 

Certificate of Verification 

32 

SOIL 

2009-11-25 17:21 

30.20 

Final 

85066 

3129 n 48 st 

em 

1" 

R. VENTRY 

ciearence 

ngnc 

± Error 

± 16.519 
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 106.433 

Supervised By: 

Certificate of Verification 

33 

SOIL 

2009-11-25 17:22 

30.89 

Final 

85066 

3129 n 48 st 

em 

1" 

R. VENTRY 

ciearence 

ngnc 

± Error 

± 14.076 
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 107.830 

Supervised By: 

Certificate of Verification 

34 

SOIL 

2009-11-25 17:23 

30.50 

Final 

85066 

3129 n 48 st 

em 

1" 

R. VENTRY 

ciearence 

ngnc 

± Error 

± 14.160 
,*^^*% 

i^,A^\ Omaha Lead Site—Fixed Price EP-R7-07-05 

I ^^^ ^ I Coastal Environmental Group Inc. Vl 

S^/^^T ^ wnww.coa8talhazmat.com 

^"tPHOi*'^ COASTA L 

c lo u r. m c 

EXECUTIVE SUMMARY: 

BVID #85066-(3129 N 48 ST) 

~y| No Issues or Concerns Q Issues/Concerns 

Detail Explanation: 

-DAN GARVEY WALKED THE PROPERTY ON 4/15/10 
M 

EPA Property Close Out Form 

Property #: JrSO.(ii,Cp Property Address: 

Date/Time: Owner's Nanr: 

Quads Excavated: Contractor Group 

Excavation General 

1. If nccessaiy, were the correct qtiadrant(s) excavated and restored? 

2. If necessary, were the correct areas ofdrip zone excavaied and restored? 

Grading Sod and Venctetion 

I. Does the {Fading around the perimeter ofthe house in excavaied areas generally slope away 

from tbe house? • 

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

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

day time period) , 

4. Are sodded areas geneiilly fimi and evenly graded? 

5. Are the joints 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 property^ 

7. Was damage to landscaping or plant materials avoided? 

Gates. Fences and Retaining Walls 

I 1. Do gates open and close fi«ely? (If applkable) 

2. Were all gates or fences taken down during restotation activities reinstalled? (If applicable) 

3. Was damige to gates or fences avoided? (Ifappiicable) 

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

Foundation, SidiBK and Gntiers 

1. Was damage to the siding or trim avoided? 

2. Was damage to the foimdation avoided? 

3. Was damage lo windows avoided? 

4 Was damage to windows or door screens avoided? 

S. Was damage to downspouts or downspoul extensions avoided? 

Sidewalks and Driveways (Concrete) 

1. Was damage to driveway surfaces avoided? 

2, Was damage to walkway surfaces avoided? 

Yes No 

/ 

/ 

Yes No 

/ 

/ 

/ 

/ 

J 

y 

y 

Yes No 

/ 

7

/ 

/ 

Yes No 

J 

/ 

/ 

/ 

^ 

Ves No 

/ 
Ort'tjers conmients: 

I 

[!n.«!pection notes: 

^y 

^0 

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

EPA Representative ^c/ j ^ ' Date: ii [ _ 
Property Compietion Agreement 

Ihis agreement documenls ihe complclion ot remedial aciiviiies perlbimed on my properly My signaiuie 

will designate ihal I am salisfied with the restoralion of my properly, and that no items are in queslions. 

now, or al any lime in the fuluie, except those ilems listed below, if any 

PropertylD: g^gQU j 

Property A6,r-^\^t\ ' ^ ifg ^ 

Restoration Items in Question: 

Item: 

ttem: 

Item: 

Item: 

Item: 

Item: 

IVI I R|;rcc I'Ktoralion is completed, except as nnieri 

[ J I rio not A|>rec restoration it, completcrt 

.^-j(/r/o Pyni^mh,^ yz(f-iD 

Date Cftnti arlor's Signature Date