TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: '^"iHh Date: S | (p / 

Address: l/j Vo \l\x) ut ^o ^ 

Remediation Contractor: Coastal Environmental Group_ Year: _2010ARRA 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

ef Video of property (DVD) 

ef Executive Summary 

/ EPA-provided property sketch 

Signed Access Agreement for subject property 

'TT Signed Access Agreement(s) for adjacent property 

/ Restoration Agreement 

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

Confirmation data 

y Photographs W h^Co^f^VO^ ^ ^XClk\/M]o^ Y C,^^ 

.0 / As-built sketch 

Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 

Description ofareas not meeting ROD cleanup criteria 

y Utility clearances 

Property information from Douglas County Assessor's Office 

30261013 

Superfund 
VV 

Property Access Checklist 

Property TD: ^T-^fetV 

D WORK STARTED ON: __/__/_ 

n WORKCOMPELTED ON: / / Property Address: ^ ^ ^Z^ btff^i o S^ T 

Owner: CCh Renter: 

^ A OnrygJAue^ 

Address: 

Phone: t/t/uf>y2^r 

Fax: 

Cell/Pager: 

D Notification Letter 

^ Access Agreement 

1^ Restoration Agreement 

D Topsoil Sampling (if applicable) 

D Disposal Sampling (if appUcable) 

Q Garden Sampling (if applicable) 

D Utility Clearance 

{p Video/Photos (Before) 

D Video/Photos (During) 

D Video/Photos (After) 

D Video/Photos (30-Day) 

[~l Property Completion Agreement 

D Final Report 

Air Monitoring (as applicable) 

• Community • Crew 

Results: 

n Conununity H] Crew 

Results: 

• Conununity • Crew 

Results: 

On: /

On: /

On: /

Phone: 

Fax: 

Cell/Pager: 

Additional Infomiation: 

Sent: / / By: 1 

Signed: V) I \w l \L; By: V>VcAc 

Signed: vo/ \M/ xO By: \->>Ue 

/ / By: 

/ / By: 

/ / By: 

CaUed: / / By: 

On: vo / v'A. / vO By: Vi><J ^ 

On:

On:

On:

Signed:

Issued:

 / 

/ 

/ 

/ / By: 

/ / By: 

/ / By: 

/ / By: 

/ / By: 

By: 1 

By: 

By: 1 

Ontaha Lead Site 
Douglas County Account Infifl|aation Page 1 of2 

Douglas County, Nebraska Property Record - R0747550000 

Print Reoort 

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

New Feature •* -^ •¥ Subdivision Sales Search 

Owner 

CiTY OF OMAHA 

C/O CITY FINANCE 

1819 FARNAM ST 

OMAHA NE 68183-0000 

Property Informatio n 

Key Number: 4755 0000 07 

Account Type: Ex Government 

Parcel Number: 0747550000 

Parcel Address: 2620 BLONDO ST 

OMAHA NE 68111-0000 

Legal Descri'ption: CARLBERGSUBDIVL0T3BL0CK1 E 16 FT LT7& ALL 16 X 37-38 X 137.64 

Value Informatio n 

2010 

2009 

2008 

2007 

2006 

2005 

Land 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

$400.00 

Improvement 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

Total 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

$400.00 

Show All Transactions 

Land Informatio n 

4cres SF Units DepHi Width Vacant 

0.01 592.0 1.0 37.0 16.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accouritno=R074... 9/2/2010 
3/31/2011 wnAw.dhon.org/irthinternet/DHONNotic 

Create Another Ticket"] ["Back^fft ^m h Intemet) E * [ Send EmaJI^] 

YOUR TICKET NUMBER IS 2699982. 

Original Call Date; 3/31/11 Time: 12:52 pm Op: ALFONSO18790 

Work to Begin Date; 4/04/11 Time: 1:15 pm 

State: NE County: DOUGLAS Place: OMAHA 

Address: 2620 Street: BLONDO ST 

Twp: 15N Rng: 13E Sect-Qtr: 09-SE,16-NE 

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 LEVEL3 MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact nione Number 

Utility 

Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

AH: 4029340469 

Emerg: 4029329757 

LEVELS LEVELS COMMUNICATIONS, 

LLC NA 

Day: 8773668344 

AH: 

Emerg: 8773668344 

MUDOl METROPOLITAN UTILITIES 

DISTRICT SANDY MUD

Day: 4025047823 

 AH: 

Emerg: 4025047970 

Day: 4024447197 

CITY OF OMAHA- OMAHACOF RICH/mAFFIC AH: 4024445161 TRAFFICSEWER 

Emerg: 4024445160 

dhon.org/irthintemet/.../MessageText.as.. 1/2 
3/31/2011 ^ ^ www.dhon.org/irthinternet/DHONNotic..^^ 

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0PPDGPR5

W

 OMAHA PUBLIC POWER

 j^j3^^ ^

 W

 ELM

 LOCATING

 Day: 4067289343 

 , / ......,.« . 

 ^ ^ 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK

FTM 

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LOC A UN CJ 

Day:

 AH:

 4067289343 

 4062071494 

Emerg: 8887289343 

dhon.org/irthinternet/.../MessageText.as... 2/2 
As-Built Drawing 

C OASTA L Omaha Lead Superfund Site ENVIHOMHtNTAL 

C n O U r . INC . 

OLS#: 27264 

Date Excavated: 4/6/2011 

Date USEPA Sianed Off: 4/21/201 

27264 Area Sodden: 1463 so ft 

Omaha Exterior Paint Lead Site 

Sit • Good e Sketch m Poor 

Sampling Address: 2620 BLONDO ST n f Not paint \ 

Sample Numt>er Lead Sample Samples Collected 

I 

LAB Concentration Collected Fimn 

RYASCPXA-27264 Fl 12 . ppm n Date al20d 

RYBSCPXA-27264 F2 L i Q ppm D Time 

RYCSCPXA-27264 B1 _j_ll_pp m D Samples Analyzed RYDSCPXA-27264 B2 Z8 3 ppm IB 

^^DgOOPMiii P?C04 Dg = ppm D D XRF Unit: 6>5H2 Book: 193 

nogocp)(A-27i!»<—se ~ ppm D D Date f o - l l -g- l 

Lab RYDSCPLA-27264 " " ppm D D Time AtL 

S Result 702 ppm Staff Number of Samples = t| h w 

Legend F1 = Front Left, F2 = Front Right, B1 = Back Left, B2 = Back Rigftt DZ = Drip Zone. GZ = Garden, PZ = Play 

All quadrants are as viewed from ttie street, racing properly 

ENTEREjD 

702 t'PM :OCT 0 2 20(17 

82 = 125PPI\/I@4" 

/3P. 

y.<^ 

V>J 

- r 4 Zliisd.'.-

EA=124PPM @ 1" 

gylcMjIo $>• C««cd IM;**)?! ! 15 1.^ 

Legend 

Concrete Drip Zone Excavated Quadrants Excavated 

Area replaced with 

Sod 

Area replaced with 

Rock/Mulch Area left bare 

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

27264 

Omah Exterior Paint North Arrow a Lead Site 

Sit Q Good e Sketch 

n Poor 

Sampling Address: 2620 BLONDO ST r 7 Not paint f 

Sample Lead Sample Samples Collected Number 

i 

LAB Concentration Collected Firm: Tp/) ^VO • Cl 

RYASCPXA-27264 Fl J2. ppm D Date: ^\lfi )o1 

RYBSCPXA-27264 F2 iRCt ppm 

D Time: U53 

RYCSCPXA-27264 Bl 1 IH ppm D 

Samples Analyzed 

RYDSCPXA-27264 B2 Z S 3 ppm IB 

RDJOOP)W OiipCH on 

ppm n D XRF Unit: 6>6H 2 Book: 1^ 3 

ROnCCPXA-27i!04 ©2 — ppm D Date: / a - 11 ' Q l — D

ppm D Time: k H J. Lab RYDSGPLA-27264 D 

8 Result Staff: M<;W 702ppm Number of Samples = | '^ ' [_[ 

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

All quadrants are as viewed from the street, facing property 

ENTERED 

'OCT 0 2 20(17 
27264 

Omaha Lead Site Exterior Paint North Arrow

• Good Site Sketch n Poor 

Sampling Address: 2620 BLONDO ST [ J Not paint f

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

Firm: 

Samples Collected 

RYASCPXA-27264 F1 .2Z ppm D Date: ^\l ^ )o1 

RYBSCPXA-27264

RYCSCPXA-27264

RYDSCPXA-27264

 F2 

Bl 

62 

li^ O 

1 IH 

ZS 3 

ppm 

ppm 

ppm 

D 

D 

IB 

Time: \'-*n 

Samples Analyzed 

RDZOODO'i DTDOA DD ppm D XRF Unit: 6i6H 2 Book: 19 3 

ROgOCPXA 27204 e£ — ppm a Date: /Q - / 1 - 6 1 

Lab RYDSCPLA-27264 — ppm n Time: KK\ 

i Result 702 ppm Number of Samples = | i\ [ [ [ Staff: ilS W 

Legend: F1 = Front Left, F2 •• Front Right, Bl = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from ttie street, facing property 
27264 

Omaha Lead Site Exterior Paint r^orth Arrow 

Site Sketch • Good 

nPoo r 

Sampling Address: 2620 BLONDO ST Q Not paint 

Sample Number Lead Sample 

Samples Collected 

I LAB Concentration Collected Firm: 

RYASCPXA-27264 F1 

ppm 

D Date: °iU^ hi 

RYBSCPXA-27264 F2 ppm 

D Time: \1S1 RYCSCPXA-27264 81 ppm D 

Samples Analyzed 

RYDSCPXA-27264 82 2:g3 

ppm IB 

ppm D XRF Unit: 6y6HZ Book: 19 3 

ROHOOPXA 27204 «Z 

ppm D a Date: / a - 11 ' 6 1 

ppm 

D

Lab Time: k M RYDSCPLA-27264 D ..... I i Result 702 ppm 

Staff: M<;W 

Number of Samples = | i\ i [ I 

Legend: F1 = Front Left, F2 = Front Right, Bl = Back Left, 82 = Back Right DZ = Drip Zone. GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing propeity 

E] NTERED ; 

1 OCTlf 12 20(1 7

0: 

^ Vi n.4 ,,..!- > 

: 

' 61 

....• % 

2U Pi ^IfiA ^ 

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C 0 >' S "1 A I 

IhVlRO^f.t r T/.t 

Coiif;eii\ ji)f Ac:cc^.s;i^ 'i o riopeii y 

RiGH7 OF ENTRY TO PREMISES 

Grsntoi (the properb,' ownei) conserit^. to and aulhoriies the United States 

Environmental Protection Agency (FPA) oi its sulliorized representatives, collectively 

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

following described premises: 1'^'7 f cS 

Owner's Nan'ie: Daytime Phone: 

^/•r ^ Of Oi^/\AHA H^^ H^'i^ 

Address of Property 

covered by this 

Agreement: ^loW '^Lomo ^ 

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 
 c 

c •-. ^'/.- ^ 9 

l^Vl^o••^^^t*. [ 

CHOL' '

' Remove obstructions incluriing boats, traileis, vehicles, plsyscape iiemr, vvciod 

piles, doo houses, etc; 

' Remove flov^'ei bulbs oi plants tfial the Grantoi or the Gianlni's lencnl may wish 

to save; 

' Water and maintain leplacement vegetation, including feriilizer application, as 

necessar)' subsequent to an initial Vv'atering period by EPA; 

' Abide by heslth and safety guidance provided by EPA; 

<• If the property' is rented, assist EPA in obtaining tenant appiova! foi access lo 

the property to perform the work. 

t Allow videotaping and/or photographing of the properly. 

AGREEMENT NOT TO INTERFERE 

The Grantor agrees not to interfere or tamper with any of the Vv'ork activities, oi v/ith 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 

0 1 grant access to my properties • I do not grant access to my properties 

Date Signeture Date 

O i Vt'ouid [ike to be ptesent durirtg any ssmplirig tt\£i is leqi/ited. 

' »•

Paoe 2 of 2 
C C A. S T A, L E N V t HONM C NTA L 

c n o u ,r , 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). 

I P^op^*-^^- &7H-15SOOOO — Z7Z0 Y 

Property Address: ^I Q g^^^ g ^ 

Owner: ^./TY o r 0/^P>» ^ 

Phone: HH^ MlMgi 

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: 

Item: 

Item: 

Item: 

Page 1 of. 
C O A S T A, L 

C N O U I 

Items to Be Removed By Contractor During Remediation and Replaced 

Item 

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 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc, 

.Attach a sketch of the 

sprinkler lavout. 

Number of and size of 

each garden/ flower bed 

area. 

.Alitich a sketch of relativ t 

sizes and locations. 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

Note tills value \vill hc 

userf lo is.siie a phiiK 

NdiicliiM' 1(1 the proprri) 

OWIU'l. 

Easement Area, to be 

excavated 

Quantity 

V1.-^ 

?/ 

^ 

i 

y 

\ 

Landscape Inventory 

Unit Condition/Type/Species 

Quadrants 

Each 

Each 

Each 

Each 

Square Feet 

$ 

Each ^'^ijyn^y^^'^'^^^i ^ 

Page 2 of. 
( ^ 

C O A S T J% L • NVinONMINTA L 

C ft O U P , t N C. 

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. 

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

• 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. 

I agree [HI I do not agree ^ 

((p- I H- 10 

^jJ^Owner's Signature Date Contractor's Signature Date 

Page 3 of. 
% 

BVID# 7^2{ ^ 

XRF PROPERTY SAMPLE SHEET 

Date 

Project 

y ) 9^yr.o(i 

Omaha Lead ARRA 

Address 

Sample time 

XRF ID# 3COR9 sample length 

Shot# Reading Sample area Shot# 

5 15c>,-T^t \^.7 ?>2 \ 

IP \05.lD t \^.5 ^ Depth Z 

1 120 li t 1^3"! M " 3 

Average \1Z\^ 1 ^ \U1 \ Average

Shot# Reading Sample area Shot# 

Depth 

Average Average 

Shot# Reading Sample area Shot# 

Depth 

Average Average 

RETEST AREAS 

Shot# Reading Sample area Shot# 

7 Depth 

x 

/' 

Average Average 

Signature_ 

Print %\f^y M/nP( 

^(op7 l 1^/iyydo ^ 

am/pm 

30 sec 

Reading Sample area 

io\A^^)T m^u FA 

i?.^^Stn.DS Depth 

\?H-\\X\\^%o, y 

 \V\ .<^ ± W^-in 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Reading Sample area 

Depth 
• • 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 l^iddlesex Turnpike 

Billerica, r^A 01821 

Certificate of Verification 

XL3t-32089 

Reading No 8 

Mode SOIL 

Time 2011-04-08 10:01 

Duration 91.57 

Sequence Final 

Flags 

AVERAGE Avg of 5-7 

ADDRESS 2620 BLONDO ST 

QUADRANT 82 

DEPHT 4" 

XRFTECH C.PADILLA 

MISC CONFIRMATION 

NOTE CLEAR 

ppm Error 

Mo < LOD 8.427 

Zr 476.389 ± 16.816 

Sr 180.597 ± 9.614 

U < LOD 15.565 

Rb 67.424 ± 6.841 

Th 12.331 ± 8.195 

Pb 125.525 ± 16.713 

Se < LOD 6.066 

As < LOD 22.409 

Hq < LOD 13.202 

Zn 189.698 ± 24.475 

w < LOD : ^—-) 92.374 

Cu < LOD y / 34.065 

Ni < LOD / 83.513 

Co < LOD / y: ' 209.318 

Fe 21300.631/ ± y 436.091 

Mn 676.413^ , 121.101 y 

Supervised By: \ Zy^ 
• • 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 5 

Mode SOIL 

Time 2011-04-08 10:00 

Duration 30.53 

Sequence Final 

Flags 

BVID 27264 

ADDRESS 2620 BLONDO ST 

QUADRANT B2 

DEPHT 4" 

XRF TECH C.PADILLA 

MISC CONFIRMATION 

NOTE CLEAR 

ppm Error 

Mo < LOD ; 8.613 

Zr 473.589 ± 16.931 

Sr 181.988 ± 9.732 

U < LOD 16.101 

Rb 67.108 ± 6.937 

Th 13.179 ± 8.591 

Pb 150.753 ± 18.205 

Se < LOD 6.217 

As < LOD 23.508 

Hg < LOD 13.524 

Zn 186.318 ± 24.637 

W < LOD : 96.458 

Cu 37.836 ± 23.773 

Ni < LOD : 80.759 

Co < LOD : 213.126 

Fe 21621.939 ± 443.185 

Mn 682.341 ± 122.680 

Supervised By: 
• • 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpil(e 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 6 

Mode SOIL 

Time 2011-04-08 10:00 

Duration 30.51 

Sequence Final 

Flags 

BVID 27264 

ADDRESS 2620 BLONDO ST 

QUADRANT B2 

DEPHT 4" 

XRF TECH C.PADILLA 

MISC CONFIRMATION 

NOTE CLEAR 

ppm Error 

Mo < LOD \ 8.501 

Zr 479.272 ± 16.782 

Sr 183.820 ± 9.648 

U < LOD : 15.452 

Rb 65.638 ± 6.730 

Th 11.891 ± 7.913 

Pb 105.609 ± 15.539 

Se < LOD ; 5.914 

As 26.267 ± 14.420 

Hg < LOD • 13.350 

Zn 183.813 ± 23.995 

W < LOD : 90.928 

Cu < LOD • 34.254 

Ni 97.514 ± 57.911 

Co 297.640 ± 141.844 

Fe 21463.967 ± 435.565 

Mn 678.073 ± 120.713 

Supervised By: 
• • 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 7 

Mode SOIL 

Time 2011-04-08 10:01 

Duration 30.53 

Sequence Final 

Flags 

BVID 27264 

ADDRESS 2620 BLONDO ST 

QUADRANT B2 

DEPHT 4" 

XRF TECH C.PADILLA 

MISC CONFIRMATION 

NOTE CLEAR 

ppm Error 

Mo < LOD 8.168 

Zr 476.305 i 16.734 

Sr 175.983 ± 9.460 

U < LOD 15.142 

Rb 69.525 ± 6.855 

Th < LOD 12.122 

Pb 120.214 ± 16.394 

Se < LOD 6.068 

As < LOD 22.087 

Hg < LOD 12.733 

Zn 198.963 ± 24.793 

W < LOD 89.737 

Cu < LOD 32.282 

Ni < LOD 82.912 

Co < LOD 202.061 

Fe 20815.982 ± 429.521 

Mn 668.827 ± 119.911 

Supervised By: 
• • 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

ppm 

< LOD 

473.516 

160.553 

< LOD 

70.900 

< LOD 

124.908 

< LOD 

< LOD 

< LOD 

145.404 

< 

38 

< 

< 

18993 

659 

Supervised By: 

Certificate of Verification 

4 

SOIL 

2011-04-08 09:58 

91.90 

Final 

Avg of 1-3 

2620 BLONDO ST 

EA 

1" 

C.PADILLA 

CONFIRMATION 

CLEAR 

Error 

8.280 

± 16.321 

± 8.882 

15.191 

± 6.809 

11.884 

± 16.274 

5.713 

21.709 

12.472 

21.337 

ns 

.724 

.332 

.641 

.431 

.037 
• • 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Tumpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Mo < LOD 

Zr 484.820 

Sr 153.390 

U < LOD 

Rb 72.201 

Th 14.570 

Pb 101.054 

Se < LOD 

As < LOD 

Hg < LOD 

Zn 158.750 

W < LOD 

Cu < LOD 

Ni < LOD 

Co 188.629 

Fe 18104.219 

Mn 589.224 

Supervised By: 

Certificate of Verification 

1 

SOIL 

2011-04-08 09:57 

30.87 

Final 

27264 

2620 BLONDO ST 

EA 

1" 

C.PADILLA 

CONFIRMATION 

CLEAR 

Error 

', 8.280 

± 16.356 

± 8.635 

: 14.925 

± 6.786 

± 7.933 

± 14.865 

5.337 

19.528 

12.916 

± 21.985 

87.468 

33.012 

79.003 

± 125.664 

± 390.195 

± 110.336 
• • 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2 

Mode SOIL 

Time 2011-04-08 09:57 

Duration 30.52 

Sequence Final 

Flags 

BVID 27264 

ADDRESS 2620 BLONDO ST 

QUADRANT EA 

DEPHT 1" 

XRF TECH C.PADILLA 

MISC CONFIRMATION 

NOTE CLEAR 

ppm Error 

Mo < LOD : 8.293 

Zr 481.367 ± 16.407 

Sr 160.247 ± 8.854 

U < LOD : 15.102 

Rb 72.810 ± 6.857 

Th 15.646 ± 8.422 

Pb 138.954 ± 17.058 

Se < LOD 6.227 

As < LOD 22.658 

Hg < LOD 12.426 

Zn 152.886 ± 21.692 

W < LOD : 85.882 

Cu 34.555 ± 22.259 

Ni < LOD : 77.948 

Co < LOD : 195.695 

Fe 20135.928 ± 413.295 

Mn 696.435 ± 118.680 

Supervised By: 
• • • • 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Tumpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3 

Mode SOIL 

Time 2011-04-08 09:58 

Duration 30.51 

Sequence Final 

Flags 

BVID 27264 

ADDRESS 2620 BLONDO ST 

QUADRANT EA 

DEPHT 1" 

XRF TECH C.PADILLA 

MISC CONFIRMATION 

NOTE CLEAR 

ppm Error 

Mo < LOD : 8.268 

Zr 454.361 ± 16.200 

Sr 168.022 ± 9.156 

U < LOD \ 15.546 

Rb 67.689 ± 6.785 

Th < LOD : 11.121 

Pb 134.715 ± 16.899 

Se < LOD : 5.574 

As < LOD 22.942 

Hg < LOD : 12.075 

Zn 124.575 ± 20.335 

w 

Cu 

< LOD 

48.940 

J 

± 

91.476 

23.906 

Ni < LOD I 81.044 

Co < LOD : 193.733 

Fe 18741.553 ± 403.803 

Mn 693.894 ± 119.093 

Supervised By: 
y^'% 

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

lj^^2 > < Coastal Environmental Group Inc. 

V^^^LJ ? www.coastalhazmatcom 

^"tPROt* ^ COASTA L 

ENfllONDEIITAL O O U P. I N C 

EXECUTIVE SUMMARY: 

BVID #27264-(2620 BLONDO ST) 

No Issues or Concerns \~\ Issues/Concerns 

Detail Explanation: 

-DAN GARVEY WALKED THE PROPERTY ON 04/21/2011 
Fron:ENVIROWORKS LLC. 402 934 2811 
 04/ 11 18:52 #144 P.008/009 


^ 

Property Completion Agreement 

I hii agreemeni documents (he complclion ol remedial acliviiies paionned on my piqpcriy My signature 

will (tesiynaic Ihai I am $a(it.ried with lhe rcsioiaiion of my properly, and (hal nn iteim are in questions 

now. or ai any lime tn Ihe fulure. excepi ihose uems )i»ied below, ifany 

Propert)- ID: T^ZZeM 

Property Addre*,: ^ ^ W^V^ '^T' 

0«vncr: 

Phone: H(^H-'^2^HB 

Restoration Items In Quealion: 

Item: 

Item: 

Item: 

Item? 

Item: 

Item: 

Additional Comments: 

I >V^^«yttf iMlerklien it tamplcltd, tkccpl ai niiitd 

L J > rio not itiirtt rc»l«ralian i» tompieled 

'^^I\^nyji>// 

Owner'.* onli aeioi'(Sicnmiiri: 
<« » EPA 

EPA Property Close Out Form 

^ ^ Propen, #: ^ip^Z^Ce^ ^ Property Address: 

Date/Time: Owner's Name:. /%--J 

Qusds Excavated: Contractor Group 

Excavation Yes No General 

1. If necessary, were the coirect qttadfant(s) excavated and restored? 

/ 

2. If necessary, were the correct areas ofdrip zone excavated aod restored? 

y 

Yts, No 

I Does the gr»liiig around the perimeter ofthe house in excavated areas generrdly slope away 

from the house? __^_ ^ 

Grading Sod and VegctatioB 

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

/ 

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

4. Are sodded areas genetilly flrm 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 propert>'? 

/ 

7. Was damage to landscaping or plant materials avoided? 

y 

Gates, Fences and RelainlDS Walb Ves No 

I. Do gates open and clo.« freely? (If applicable) / 

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

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

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

y 

Foundation, SidiBKsnd Gnlttrr Yes No 

t. Was damage to the siding or trim avoided? / 

2. Was damage to Ihe foundation avnidnl? / 

3. Was damage lo windows avoided? y 

4 Was damage to windows or door screens avoided? y 

5. Was damage to downspouts or downspout extensions avoided? 

/ 

1 

Sidewallts and Driveways (Concrete) Yes No 

1. Was damage to driveway surfaces avoided? / 

/

2. Was damage to waOcway surfaces avoided? 
0>»'bers comments: 

^ 

jlhspectioh notes: 

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

EPA Representative 6<y)^ _^Date: HJ«^1'1