TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: 

(n^^ Date: ^ / ^ / ^<^ U 

Address: /. t H ^M^!>U ^ )>U^ 

Remediation Contractor: Coastal Environmental Group_ Year; 2001 

• ^ 

SOIL REMEDIATION 

PROPERTY nL E FOLDER DOCUMENTS 

Video of property (DVD) 

Executive Summary 

EPA-provided property sketch 

i/ 

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.) 

Confinnation data . 

Photographs b<CfiwAi\<fM r m hccto/fii'do^ 

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 infojmflTian from Douglas Couniy Assessor" s Office 

30217875 

Superfund 
^v 

Property Access Checklist 

Property ID: . -^ ^ ^ p^ 

Property Address: 2 Zj q l^fiA-yn/y^ t^w T 

n

n

 WORK STARTED

 WORKCOMPELTED

 ON: __/__/ 

 ON: __/__/_ 

O^-'^'-'^Oy^f>>k. py^.r/iW^^A-h 

Address: '•' 

Phone^llQ^) ^U^iS^^-lQ]^ 

1 Fax: 

''^'^•-(U!V^'SOM^l\\ , 

Renter: 

Phone: 

Fax: 

Cell/Pager: 

Additional Information: 

D Notification Letter 

^ Access Agreement 

I s Restoration Agreement 

1 D Topsoil Sampling (if applicable) 

D Disposal Sampling (if applicable) 

D Garden Sampling (if applicable) 

\y[^ utility Clearance 

D Video/Photos (Before) 

D Video/Photos Paring) 

D Video/Photos (After) 

n Video/Photos (30-Day) 

1 nf^ Property Completion Agreement 

D FinalReport 

Sent: / / 

Siened: / / 

Siened: / / 

/ / 

/ / 

\J_IILI(2L 

CaUed: / / 

On: / / 

On: / / 

On: / / 

On: / / 

Sienedl2- il l lO^ 

Issued: / / 

By:

By: 

By: 

By: 

By: 

^y-nj/^lr^

By: 

By: 

By: 

By: 

By: 

By: 

By: 

 iiVL'izIz 

1 

Air Monitoring (as applicable) 

n Community Q Crew 

Results: 

On: / / By: 1 

1 IZI Community

Results: 

 JZi Crew On: / / By: 

• Community

Results: 

 Q Crew On: / / By: 

Omaha Lead Site 
Douglas County Account Infya|^on Page 1 of2 aaa^c 

Douglas County, Nebraska Property Record - R2403080000 

Print Report 

NEW Feature - Parcel Dimensions available (^ scale 0-50 ft west of 52nd St - VlO W O n Ma p Information is valid as of 2009-10-15 Treasurer's Tax Report 

New Feature •^ -> •• Auto Sales Search 

Owner 

BURGHARDT ANNETTE M 

ETAL 

2214 HANSCOI^ BLVD 

OI^AHA NE 68105-0000 

Property Informatio n 

Key Number: 0308 OOOO 24 

Account Type: Residential 

Parcel Number: 2403080000 

Parcel Address: 2214HANSCOI^BD 

OI^AHANE 68105-0000 

Legal Description: VIRGINIA PLACE LOT 4 BLOCK 2 S 6 FT LT 3 & ALL 56 X 127 

Value Informatio n 

Land /mprovemenf Total 

2009 $6,700.00 $137,600.00 $144,300.00 

2008 $6,700.00 $137,600.00 $144,300.00 

2007 $6,700.00 $137,600.00 $144,300.00 

2006 $6,700.00 $102,500.00 $109,200.00 

2005 $6,700.00 $102,500.00 $109,200.00 

2004 $6,700.00 $102,500.00 $109,200.00 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.16 7112.0 1.0 127.0 56.0 No 

Impro vemen t Informatio n 

Building 1 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R2... 10/17/2009 
Douglas County Account InfcgiMtio ^X^l l n Page 2 of2 

2 1/2 Story Fin Blrt*rt 8t«i< 8 fl 

First Ftoor Second Floor .j:-,; 968 0sq.ft. " " ThMFl««f 

4:s r >o T 

TiTr =|l : 

CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IMAGE 

Square Footage: 2323.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Fair 

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

HVAC: Central Air to Air Rooms: 7.0 

Exterior: Frame Aluminum Units: 1.0 

Interior: Drywall Baths: 1.5 

Roof Cover: Slate Bedrooms: 4.0 

Roof Type: Gable Stories: 2.5 

Floorcover: Allowance Foundation: ; Biocl< 

Sprinkler Square Footage: 0.0 

Year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1915 1960 0% 1915 94 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 962.0 

Fixture Additional Fixtures 1.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Fixture Bath Half 1.0 

Garage Detached 320.0 

Porch End Screen 128.0 

Porch Slab Roof Ceil 24.0 

Porch Slab Roof Ceil 74.0 

User Attic Full Finish 360.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R2... 10/17/2009 
"> 

Page 1 of2 

Create Another Ticket Back to Irtii Internet SendEmaij i] ]E _ J 

YOUR TICKET NUMBER IS 2413595. 

Original Call Date: 11/26/09 Time: 2:52 pm Op: ELIZABETH18790 


Work to Begin Date: 12/02/09 Time: 7:15 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 2214 Street: HANSCOM BLVD 


Twp: 15N Rng: 13E Sect-Qtr: 28-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: (877)662-4211 


: UNSURE OF CORNER LOT 


Company : COASTAL ENVIRONMENTAL SERVICE 


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


Work Being Done For: coastal 


Depth of Excavation: 4 ft Comer Lot: N Front: Y Rear: 


Involves Turmeling or Horizontal Boring : N Explosives: N 


CXCATV LEVEL3 MUD02 OMAHACOF 0PPDGPR6 QLNNEIF 


Service Area Contact Phone UtiUty Type Number 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 8773668344 

LEVELS LEVELS COMMUNICATIONS, LLC NA Alt: 

Emerg: 8773668344 


Day: 4025047823 


MUD02 METROPOLITAN UTILFTIES DISTRICT SANDY Alt: 

Emerg: 4025047970 

Day: 4024447197 

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

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 11/26/2009 
Page 2 of2 

0PPDGPR6 OMAHA PUBLIC POWER DISTRICT NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

QLNNEIF QWEST LOCAL NETWORK NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

http://vmw.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 11/26/2009 
OLS#: 17898 As-Built Drawing Date Excavated:11/30/09 

Date USEPA Sioned Off: 12/22/09 

C OASTA L Omaha Lead Superfund Site Area Sodden: 2664 so ft 

Name: ?>.-^^K;.^l,,4' 

Address; -PCll ^ 14-.^^^ ^

Phone: R'^tr- Oo-) < 

 $/,,-.( 

Omaha Lead Site 

Site Sketch 

Date:

Time:

 5?/f/c^ 3 

 ]'^''3 0 

North Arrow 

Team /VNpb (sKuXiL BVID #

Sample Numt>er 

yyAsryk 4 -11'5^9 , 

/gy^fec<^> ^ —/7g^ ^ 

) ^g"f< r

Lead Concentration 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

 XRF Code "5^0 1 

Confinnation Sample 

< Yes ° 

^;Ye s • 

^x Yes 1^ 

'^-> Yes CD 

T5zYes D 

<$ Yes • 

Yes • 

No ^ 

No [21 

No p ; 

No P ; 

No C3 

No caNo • 

^JA . 

Omaha Lead Site 46130 

Legen d 

Concret e m Drip Zone Excavated Quadrants Excavated 

Are a replace d

Sod 

 wit h Area replaced with 

Rock/Mulch Area left bare 

Contrac t #: EP-R7-07-05 Coasta l Environmenta l Group Inc . 
•J^J w (U 

Omaha Lead Site 46130 
\ AJ ll \U 

Name: ^i_r.^W.r<:i \ - Omaha Lead SKe Date: ?f A/c ^ 3 North Anow 

Address: 5 a iM l••l..-.^^r,>^ S/i.-.l Site Sketch Time: ]-^"3 0 

Phone: ^i-itr ­ Ic K 

Team/v\-p; 6^ 0 Ar t BVID# / Pg'f T XRF Code ^SO I 

Sample Numtjer Lead Concentration Confinnation Sample 

jcyAsr.yy^ ­ /7i5^^ ppm 

ppm 

< ,

k

 Yes

 Yes

 ° 

a 

No ^ 

No 121 

k-f'v:y.p\.4- ii&^ t 

l&2-»2 0 

l|3t^, | 

ppm 

ppm 

ppm 

ppm 

§x Yes

'^T. Yes

•Vit Yes

9 Yes

 Q 

n 

D 

D 

No O ; 

No ^ 

No czr 

No C2- Yes • No • 

Omaha Lead Site 46130 
Name: Omaha Lead SKe Date: W23 Nortti Anew —• 

Address.•: ..>S^I %iHt M i'...^.^on . . dliTc^^ Site Sketch Timei: M PO 

Phone: =^^<r- ^as^« r - ^ 

Team /VNp^ BVID # i '^^'f<r XRF Code 5S"0 / 

Sample Numt>er Lead Concentration Confirmatton Sample 

ppm <^ Yes a No ^ 

ppm -f;Yes a No ta KVr-'.c.f^^ei^l-/^^ ^ 

ppm S> Yes C] No g ; 

ppm •^Yes a No g ; IbZi-ZO ppm '^Yes C No t3 

ppm 9 Yes n No C3' 

ppm Yes • No • 

I^ \ \ w y ­ ' ^ ^ r^H -rH '3 ,, / -V_ ^ I15*Z J

c ^ 

fu. ^ ^~ 

)V<; 

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l^ V/ 

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nr 

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Omaha Lead Site 46130 
.•^"'i!:**. 

COASTA l IHVIXONKIHIAl 

CROUP . IHC 

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: Daytime Phone: 

Address of Property 

covered by this Z^\^ ( M<>ti05coi^ Ppi^\/9^ 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 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 wori< 

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 worit. This access shall 

remain in effect until the worit has been satisfactorily completed. The Grantor also 

agrees to: 

Page 1 of 2 
\^^0^'f

 COASTA L •/;

 . ^ tItVINOHHIKTAt 

^< «10<* C • D U > I K C 

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

piles, dog houses, etc; 

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

to save; 

t 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. 

<t Allow videotaping and/or photographing of the property. 

AGREEMENT NOT To INTERFERE 

The Grantor agrees not to interfere or tamper with any of the wort< 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 

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

^...^ /rrvlf^if^^//' ///r9/^ 9 

Signature Date Signature (J Date ~ 

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

Page 2 of2 
COASTA L 

c « e u r -M r 

Restoration Agreemertt 

The purpose ofthis agreement is to provide B 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). 

PropertylD: |~fg^ ^ • 

Property Address: £j2>t^ /^..^-g^^icvn l^Ll/ Q 

Owner: ;^'iiJF-7TC ( ^ U r^6 W/t^^DT 

Phone: [^[Qr^^^Lli^ . ^^jC^ H {.Hp? ) V^ O • H^\ t( G C 

On the attached diagram(s) indicate area(s) to excavate, surface structures and landscaping features and 

access Iocation(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: 

rtie lenoval. storage, di&posal, and/or return of these items is the Owner's responsibility. 

ttem: 

^V^oJ/{ p]c^^p ' 

Item: 

Item: 

Item: 

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

Item: 

^v^ h W ^UA7 ^ Te^A^VA-X^ 

Item: 

Item: 

Item: 

Page 1of I 
COASTA L 

Kerns to Be Removed By Contractor During Remediation and Repiaced 

Item: 5 ^ Fi., i? 

Kem: 

^^• A - y>\ .f l 

Item: 

Item: 

Landscape Inventory 

Item Quantity Unit Condition/Type/Specles 

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

is covered whh grass. 

Number of trees > 2 inch Each 

trunk diameter I 

Number of trees <= 2 inch Each 

trunk diameter ^ 

Number of Sprinkler 

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

Aiiath !i sktfich ol tlitf­

'•pripkloi lininii 

Number of and size of 

each garden/ flower bed Each 

area. Square Feet 

Aili\th ;i skcich 1)1 rclativi.' 

>i/i'S nnd loc;Mi('iis. 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

N'OK- IM' \HIIIC «II I nt 

usi'C U) isiui .1 filaiii 

^o^K•>ll.•: I d lh e |irii))Ci"l \ 

0 " ner. 

Easement Area, to be Ve4 Each 

excavated 

hei^Nuipy^ f\g3c.^(H> 

^ / Page 2 of. 
f f 

C O A S 1 A L 

O ft O U ' , • N C 

f Additional Comments / Instructions: 

c^kL^u ?<D 2- 3 Dc^^ lMtJuAiA}Cj:^ 

^Chec k 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 r~jl do not agree 

Date Contractor's Signaturr Date 

Page 3 of 7 
BVID # / -^^ ^ 

XRF PROPERTY SAMPLE SHEET 


Date I^-H-O^ 

Project Omaha Lead ARRA 

XRF ID# 

?)^nz2^ 

Shot# Reading Sample area 

7W~ £S.D3iJ/Ly5 ±JL 

IS ^ l<;t^.^L ^l^-t ^ Depth 

JJ22 /?g.«;?-^/^s2 - . la 

Average /l,0.fa ^ t }l-.£>f 

3-9.1^ f.^<;ca ^ 1^(jjif 

am/pm 

30 sec 

Reading Sample area 

//f.yt^/'h^r £L 

//>9-^^/^-^r Depth 

t$n-t>f t/S'f f ik. //'?•. 2 / ^ /<^Qg> 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Shot # Reading 

/ ^ ^ / i ^ * /^-f ^ 

/r^ ZU)0fc //.^6 H i ^^^^PC^ \ZM { 

Average yy^M > ^

Shot# Reading 

Average 

Shot# Reading 

Average 

Signature, •>CMj/mh 

Sample area 

c^/f 

Depth 

( " 

 IZ'i ^ 

Sample area 

Depth 

Address 

Sample time 

sample length 

Shot# 

tso 

4.S±. 

rs2^ 

Average

Shot# 

Average 

Shot# 

Average 

RETEST AREAS 

Sample area Shot# 

Depth 

Average 

Print 'h^h ^ CJ^^ ^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 157 

Mode SOIL 

Time 2009-12-04 09:43 

Duration 91.73 

Sequence Final 

Flags 

AVERAGE ^Avrof 154-156 ' 

ADDRESS 2214 hanscom blvd 

QUADRANT Bl 

DEPHT 6 

XRF TECH R. VENTRY 

MISC clearence 

NOTE ngnc 

ppm ± Error 

Pb 

Supervised By .^CawQJlA. 
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 155.017 

Supervised By: 

Certificate of Verification 

154 

SOIL 

2009-12-04 09:42 

30.61 

Final 

17898 

2214 hanscom blvd 

Bl 

6 

R. VENTRY 

clearence 

ngnc 

± Error 

± 16.752 
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 156.458 

Supervised By: 

Certificate of Verification 

155 

SOIL 

2009-12-04 09:42 

30.56 

Final 

17898 

2214 hanscom blvd 

Bl 

6 

R. VENTRY 

clearence 

ngnc 

± Error 

± 16.846 
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 170.572 

Supervised By: 

Certificate of Verification 

156 

SOIL 

2009-12-04 09:43 

30.56 

Final 

17898 

2214 hanscom blvd 

Bl 

6 

R. VENTRY 

clearence 

ngnc 

± Error 

± 17.516 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 153 

Mode SOIL 

Time 2009-12-04 09:41 

Duration 91.46 

Sequence Final 

Flags 

AVERAGE wg_QLl50^1 

ADDRESS 2214 hanscorfr 

QUADRANT F l 

DEPHT 6 

XRF TECH R. VENTRY 

MISC clearence 

NOTE ngnc 

ppm ± Error 

Pb C3J7.211 Lib^yyii ? 

Supervised By • ^CdMu l 
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 119.387 

Supervised By: 

Certificate of Verification 

150 

SOIL 

2009-12-04 09:40 

30.32 

Final 

17898 

2214 hanscom blvd 

Fl 

6 

R. VENTRY 

clearence 

ngnc 

± Error 

± 17.345 
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 109.238 

Supervised By: 

Certificate of Verification 

151 

SOIL 

2009-12-04 09:40 

30.56 

Final 

17898 

2214 hanscom blvd 

Fl 

6 

R. VENTRY 

clearence 

ngnc 

± Error 

± 14.945 
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 123.008 

Supervised By: 

Certificate of Verification 

152 

SOIL 

2009-12-04 09:41 

30.58 

Final 

17898 

2214 hanscom blvd 

Fl 

6 

R. VENTRY 

clearence 

ngnc 

± Error 

± 15.705 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 149 

Mode SOIL 

Time 2009-12-04 09:38 

Duration 91.97 

Sequence Final 

Flags 

AVERAGE r]^$£g^oM46-l' 

ADDRESS 2214 hanscom blvd 

QUADRANT em 

DEPHT 1" 

XRF TECH R. VENTRY 

MISC clearence 

NOTE ngnc 

ppm ± 

Pb CXLOD- ^ : 

Supervised By: [(MW ^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 146 

Mode SOIL 

Time 2009-12-04 09:37 

Duration 30.87 

Sequence Final 

Flags 

BVID 17898 

ADDRESS 2214 hanscom blvd 

QUADRANT em 

DEPHT 1" 

XRF TECH R. VENTRY 

MISC clearence 

NOTE ngnc 

ppm ± Error 

Pb < LOD 12.815 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 147 

Mode SOIL 

Time 2009-12-04 09:38 

Duration 30.55 

Sequence Final 

Flags 

BVID 17898 

ADDRESS 2214 hanscom blvd 

QUADRANT em 

DEPHT 1" 

XRF TECH R. VENTRY 

MISC clearence 

NOTE ngnc 

ppm Error 

Pb < LOD 11.857 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 148 

Mode SOIL 

Time 2009-12-04 09:38 

Duration 30.55 

Sequence Final 

Flags 

BVID 17898 

ADDRESS 2214 hanscom blvd 

QUADRANT em 

DEPHT 1" 

XRF TECH R. VENTRY 

MISC clearence 

NOTE ngnc 

ppm Error 

Pb < LOD 12.411 

Supervised By: 
iysA^\ Omaha Lead Site—Fixed Price EP-R7-07-05 

I ^^^Z ° Coastal Environmental Group Inc.

v"^^" ^ wvvw.coastelhazmat.com

^^tPHoxt*^

EXECUTIVE SUMMARY: 

BVID #17898-(2214 HANSCOM BLVD) 

No Issues or Concerns [^ Issues/Concerns 

Detail Explanation: 

 ^'>^g^ ^ 

 -"^^ 

 COASTA L • NYIIOHHINTAI 

SIOUP , IN C 
$ ^ 

EPA Property Close Out Form 

Property If. 

f i-^fe Property Address: 

Date/Time: Owner's Name; 

Quads Excavated; if^i. fel" Contractor Gronp /l^ ^ 

Excavation General 

1. If necessaiy, were the correct quadiantfs) excavated and restored? 

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

Gradins Sod and VcRelation 

I. 

Does the grading around die perimeter ofthe house in excavaied areas generally slope away 

from Ihe Iiouse? 

2. 

Has sod been laid bi all areas Out were excavated? 

3. 

Does the sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 

day tune period) 

4. 

Are sodded areas genei«Uy firm and evenly graded? 

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

time period) 

6. Was tbe properly graded such that water will not pool on lhe prnperty*) r 

7. 

Was damage to landscaping or plant materials avoided? 

Gates, Fences and Retainins Wails 

1. Do gates open and close freely? (If applicable) 

2. Were all gates or fences taken down during restoration aelivilies reinsuiied? (If applicable) 

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

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

Foundation, Sidiasand Gntters 

1. Was damage to die siduig or trim avoided? 

2. Was damage to the foundation avoided? 

3. Was damage to windows avoided? 

<l Was damage to vrindows or door screens avoided? 

 Was damage io downspouts or downspoul extensions avoided? 

Sidewalks and Driveways (Concrete) 

I. Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 

Yes No 

y 

y 

Yes No 

y 

y 

/ 

y 

y 

y 

y 

Ves No 

/ 

y 

y 

y 

Yes No 

y 

y 

J 

y 

y 

Yes No 

y 

5
I 

Ort'Dcr^ comments: 

[Inspection notes: 

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

EPA Representative '^y \ Date: >^^ 
Property Completion Agreement 

This agreement documents lhe complclion of remedial aclivities perloimed on my pioperly My signalure 

will designate liiat I am salisfied wilh lhe restoraiion of my properly, and Ihal no items are m queslions. 

now, or at any lime in the futuie, except those ilems lisled below, if any 

Property fP: p ( ^ p^ 

Property Addrcs: ^ ^/ ^ |^,O.S-rW\ , fi^lW. 

Owner: /^y^y^^j^p^ faomkaiX

f £ 

Phone: ^^ y ^ ^j^.^A ^ 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

^ ^ 1 ii|;rcc iKtoralion i% completed, except as nntect 

[_J I rio not iit;rec resloration is completed 

Cj 

]ffJ^^yl-^7r­ y^.y-j^ ^ 

Owner's Signatn^^^ ^ Date ontrarlor's Signature Dale 
Propertv Owner Sctisfartion Surveyi 

Omaha Lead Superfund Sit 

2008 

Remediation Contractor: Coastal Environmental Group _ OEC 2 4 2(109 

Property Identifier Number: s2m 

Property Address: 2Z) a ' lA/Jt^fi r .Cyrfi ^ i tc l 

Property Owner's Name; JV^ne-H? > \n\)r<^(:ih ^ 

(above information to be filled out by remediation'conlractor prior to delivery of form to Property Owner) 

Instructions to Property Owner: 

This form 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) is very interested in your opinion regarding 

the work performed by its contractors. This form is intended to provide an easy means for you to 

express your opinion about the work performed on your property. 

Please indicate your level of satisfaction with the contractor's worl< by selecting a numerical 

rating (ranging from 1 to 10) using the following rating scale, then please sign and date the form and 

return it to the USEPA in the attached self-addressed & stamped envelope, (additional comments may 

also be provided in the space below, at the option ofthe property owner.) 

9-10 "excellent" 

7-8 "very good" 

5-6 "acceptable" 

3-4 "poor" 

1-2 "very poor" 

Property Owner's Satisfaction Ratlrie Regarding Contractor's Work 

10 5 

A 

3 * 

2 

1 

Additional Comments from Property Owner (optional: continue to back of page if neededl 

Property Owner's Signature: D,,e. y /70 ^