TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: V/^ 1 ^ Date: "^ | \l k 

Address: ^I^ H f^t^j^eW C ^^j ^ 

Remediation Contractor: _Coastal Environmental Group_ Year: _20i d ^ 

SOIL REMEDIATION 

PROPERTY nL E FOLDER DOCUMENTS 

/ Video of property (DVD) 

Executive Summary 

5 / EPA-provided property sketch 

^ Signed Access Agreement for subject property 

-B^ Signed Access Agreement(s) for adjacent property 

B Restoration Agreement 

• ^ Settlement dociunents (i.e., for damage or to replace plants, etc.) 

-6- Confinnation data 

IZ Photographs (T^^I^ITU ^ ^ \ H tiO^>tl/l'<1W^ 

^ As-built sketch 

0 Satisfactory restoration signed by Property Owner 

5/ Property close-out check list signed by EPA 

G-. Description of areas not meeting ROD cleanup criteria 

B Utility clearances 

!u Property inflSrn^tion from Douglas County Assessor's Office 

Date 

Superfund 
# 

Property Access Checklist 

PropcTT^lD :|^7)f)4 \ 

Prcpcr,vAddre»:2nMM V^T}^Y\^\ ^ 

O

D

 WORK STARTED

 WORK COMPELTED

 ON 

 ON: 

_/

/

 /_ 

/ 

0-- ' '31J\K) S \AJo\-f f 

Address; ^ot^V\jl_ 

Phone 1^1-7 , -^Q-j ^ 

Fa^: 

Ccll/Pager. 

Rcnier 

Phone: 

PAS: 

Cell/P»ger: 

Additional InlnrmKtion: 

D Notificiilion Letter 

wAccesi Agreement 

¥ Restoriition Agreement 

D Topsoil Sampling (if ipplicuble) 

Q Dispo5tU Sampling (K ^applicable) 

O Gnrdcn Snmpliog (if applicable) 

Q JUtiliiy Clearance w^Video/Phofos (Before) 

D Video/Pholos (During) 

D Video/Photos (After) 

Scnl: 

Signed: Jl/25/ ^ 

Signed: ^/2&/fl a

Called: 

On:'^/Z5^i2^ 

On 

On 

Bv: 

g> O^ Wv'b 

 ^y\(^V\\r\ { 

By: 

By: 

By: 

By: 

By: J^ChM^ 

Bv: 

By: 

D

tJeo/PholOJ (30-Day) 

ropcrty Completion Agreement 

 Final Report 

OD / / 

Signed:^?." )

Issued: 

/ ^ 

By: 

By: 

By: 

Air Monitorint; (iia applicable) 

D Communrty D Crew 

Results: 

OD: / / By: 

D Comrounirc

Results: 

Q Crew On: / / Bv: 

D Communiri

RetulU: 

D CrL'»v On: / / Bv: 

Omaha Lead Srte 
Property ID # 

Property 

Address: 

Initial Contact: 

Second Contact: 

Final Contact: 

Final Action: 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

CONTACT FORM 

U>1S5M\ 

11M4 fonVf.r^fAW ^r> 

Date: Time: Action: 

Date: Time: Action: 

Date: Time: Action: 

Transmit to EPA D Other Action: D 
Douglas County Account InfornMjion Page 1 of3 •rnu^c 

Douglas County, Nebraska Property Record - R0811830000 

Print Report 

NEW Feature - Parcel Dimensions available (® scale 0-50 ft west of 52nd St - Vie w OH Ma p Information is valid as of 2009-6-16 Treasurer's Tax Report 

New Feature - • ^ •• Auto Sales Search 

Owner 

WOLFE JULIUS L 

ETAL 

2744 FONTENELLE BLVD 

OMAHA NE 68104-0000 

Property Informatio n 

Key Number: 1183 0000 08 

Account Type: Residential 

Parcel Number: 0811830000 

Parcel Address: 2744 FONTENELLE BD 

OMAHA NE 68104-0000 

Legal Description: CLAIRMONT LOT 3 BLOCK 5 50 X 125 

Value Informatio n 

Land Improvement Total 

2009 $6,400.00 $83,000.00 $89,400.00 

2008 $6,400.00 $83,000.00 $89,400.00 

2007 $6,400.00 $83,000.00 $89,400.00 

2006 $6,400.00 $83,000.00 $89,400.00 

2005 $6,400.00 $77,000.00 $83,400.00 

2004 $6,400.00 $70,000.00 $76,400.00 

Sales Informatio n 

Sales Date: 2001-11-12 

Deed Type: WD Book: 2197 Page: 18 

Price: $87,000.00 

Grantor: 

GrantBe: 

Valid/Invalid: Valid 

Exclusion Reason: Multiple 451-Parti Int Valid 

Sales Date: 2001-11-12 

Deed Type: WD Book: 2197 Page: 19 

Price: $1.00 

Grantorhttp://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R081... 7/7/2009 
Douglas County Account Inforrmjon Page 2 of 3 rin^c 

Grantee: 

Valid/Invalid: Invalid 

Exclusion Reason: Multiple 451 Parti Int Invalid 

Sales Date: 2000-09-05 

Deed Type: D Book: 2162 Page: 193 

Price: $6,506.00 

Grantor: 

Grantee: 

Valid/Invalid: invalid 

Exclusion Reason: Sale by Govt Agency 

Sales Date: 2000-08-29 

Deed Type: Book: 2162 Page: 047 

Price: $29,000.00 

Grantor: 

Grantee: 

Valid/Invalid: Invalid 

Exclusion Reason: Foreclosure 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.14 6250.0 1.0 125.0 50.0 No 

Improvemen t Informatio n 

Building 1 

I74< FONTENEUE BD 

n m ROOT Second Roar 

BM 0 «q *.- 7 « a «I ft 

2 STORY 

B«frr« Black B B 

OB.On). ft. 

i9it'<;n]'CM .i r 

< -fi ' P tq (1 

CLICK CLICKJO ENLARGE IMAGE TO ENLARGE IMAGE 

Square Footage: 1584.0 Percent Complete: 100.0% 

Perinneter 0.0 Quality: Average 

http://douglasne.mapping-online.com/DouglasCoNe/static/accoiintinfo.jsp?accountno=R081... 7/7/2009 
Douglas County Account Infonn||io >n4|g n Page 3 of3 c 

Unit Type: 

Built As: 

HVAC: 

Exterior: 

Interior: 

Roof Cover: 

Roof Type: 

Floorcover: 

Year Built 

1918 

Detail Type 

Appliance 

Appliance 

Basement 

Fixture 

Fixture 

Garage 

Porch 

Porch 

2 Story 

Central Air to Air 

Frame Siding 

Drywall 

Composition Shingle 

Gable 

Allowance 

year Percent 

Remodeled Remodeled 

2001 0% 

Detail Description 

Allowance 

Fireplace Masonry 

Bsmnt Block 8 ft 

Base Fixtures 

Bath Full 

Detached 

End Screen 

Slab Roof Ceil 

Condition: 

Condo Square Footage: 

Rooms: 

Units: 

Baths: 

Bedrooms: 

Stories: 

Foundation: 

Sprinkler Square Footage: 

Adjusted Year 

Fair 

0.0 

7.0 

1.0 

1.0 

4.0 

2.0 

Block 

0.0 

Physical Age Built 

1980 29 

Units 

1.0 

1.0 

836.0 

1.0 

1.0 

192.0 

42.0 

162.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accoiintinfo.jsp?accovintno=R081... 7/7/2009 
Page 1 of 1 

% 

[ Create Another Ticket j [ Back to Irth Intemet | I Send Email ] 

YOUR TICKET NUMBER IS 2333471. 

Original Call Date: 8/04/09 Time: 3:26 pm Op: ELIZABETH18790 


Work to Begin Date: 8/06/09 Time: 4:00 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 2744 Street: FONTENELLE BLVD 


Twp: 15N Rng: 13E Sect-Qtr: 08-NW-SW 


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 


: UNSURE ABOUT CORNER LOT 


Company : COASTAL ENVIRONMENTAL SERVICE 


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


Work Being Done For: Coastal 


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


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

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-TRAFFICSEWER RON 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 8/4/2009 
As-Built Drawing 

COASTA L Omaha Lead Superfund Site 

63541 

Extenor Paint Nort h ArTCTW Oniah a Lea d Sit e 

Sit ( 2 Good e Sketc h • Poor 

Sampling Address: 2744 FONTENELLE BD I I Nof paint 

Sample Number Lead Sample LAB Samples CollectejJ 

Concentration Collected 

Firm: fP A P g • A J 

RYASCPXA-63541 Fl ppm n

Date; q -22- - Of i 

RYBSCPXA-63541 F2 i-iq 3 ppm n Time: l2-'3 0 ^tA 

RYCSCPXA-63541 B1 -LS-i. ppm a 

Samples Analyzed 

RYDSCPXA-63541 B2 2 0& ppm D 

RDZSCPXA-63541 DZ 

30,1 0 ppm i n XRF Unit: foSH O Book: 2.2 0 

nOZCCPXA-63S41 Q2-

ppm D Date: IO • 2 B "O S 

RPZSCPXA-63541 PZ 

6>8 ppm n 

Time: flm ^ 

Staff: <rTSL«> Number of Samples • ra 

Legend: Fl = Front Left. F2 = Front Right, B1 = Back Left, 82 = Back Right DZ = Drip Zone. GZ = Garden, PZ = Plai 

All quadrants are as viewed from the street, racing property 

Rv*\' :<«18 Crened: 27-,>ugLegend 

Concrete Drip Zone Excavated Quadrants Excavated 

Area replaced with Area replaced with 

So Area left bare d ' ' Rock/Mulch 

Contrac t #: EP-R7-07-05 Coastal Environmental Group Inc . 
63541 

Omaha Lead Site Extefior Paint 

Site Sketch 13 Good 

• Poor 

Sampling Address: 2744 FONTENELLE BD [|] Not paint 

Sample Lead Sample Samples CollectejJ Number 

I 

LAB Concentration Collected Fimi: fP A n^A J 

RYASCPXA-63541 Ft ppm D Date: ^-U-OP, 102.. RYBSCPXA-63541 F2 ppm D Time: lZ'-30 p^»^ 

RYCSCPXA-63541 Bl —USJ ppm D L Samples Analyzed RYDSCPXA-63541 82 ppm D 

RD2SCPXA-63541 DZ ppm D XRF Unit: foSH O Book:22Q 3(P2 0 

nCZCCPXA 63S41 S2- ppm D Date: _ 

RPZSCPXA-63541 PZ ppm n Time: _ flry,

Staff: Numbe • ^^t ^ r of Samples = | (^ \ \ Q | 

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

All quadrants are as viewed from the street, facing property 

^ 

o 

JD irmi H '-rciKct :7-.\ug-i>K 

e^ 

^ 
63541 

Omaha Lead Site 

Site Sketch 

Bcterlor Paint 

ffl Good 

• Poor 

North AfRMv 

Samolina Address: 2744 FONTENELLE BD • Notpaint 

Sample Lead Sample 

Samples Collecte$l Numtwr 

I 

LAB Concentration Collected F\m: 

RYASCPXA-63541 Fl /OZ ^ ppm n Date: Q-2Z-0ft 

RYBSCPXA-63541 F2 >~»q 3 ppm D Time: IZ.30 OiA 

RYC8CPXA-63541 Bl xai. ppm 

D Samples Analyzed RYDSCPXA-63541 B2 2^)8 ,PPm D 

RDZSCPXA-63541 DZ ppm D XRF Unit: &^H 0 Boole 22 0 

RCZSCPXA-63541 82- .ppm 

D Date: IO'2B-o S 

RPZSCPXA-63541 PZ ppm 

D 

Time: flrv. 

Staff:. msA^ Number of Samples = | (^ \ | ( ^ | 

Legend: Fl = Front Left, F2 = Front Right, B == l BacK Left, B2 = Back Right DZ ^ Drip Zone, GZ •> Garden, PZ = Pla; 

All (|ijadrentd s n B& vlowsd from ths tfreot, fsdng praporty 

OCT 2 7 208B 

6iB 

, ^ ' yl. 

•^1 

Onti 

S^ 

flZ» a^2<?. 

[ .27<rf : 

Bv. 

R<\':inil Created: 27-.\ut-l>S 
COASTA L ENVmONHINTAl " t PHOtt^ G • 0 U P . 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: 

Owner's Name: /^M^PLA - UjCrUFEr^ Daytime Phone: (^11-^Ol ^ 

Address of Property 

covered by this 27'^cf fbore^^J^tJLe ^^^V2^ 

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 underthe 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 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 wori(. This access shall 

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

agrees to: 

Page 1 of 2 
^tt o «r4. 

COASTA L ENVrKOHMENTA L 

CROUP ,

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

piles, dog houses, etc; 

e 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; 

e Abide by health and safety guidance provided by EPA; 

e 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 work 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 

'!^fgrant access to my properties Q I do not grant access to my properties 

cn-a^-o'i 

Signature Date 

O I would like to be present during any sampling that Is required. 

r N C 

Page 2 of 2 
^ .C .> l i S T i-V I 1 •iHvmo*"^'*'"' ^ 

The purpose of this agreement is to provide a mutual agreemenl as to conditions ofthe property prior lo 

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). 

Property m= Q.I^IC^^ T 

Property Addr^s A^^, U u.^t;^F6 s Z7V^ V Tr^^^&^ U /) ^ 

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. 

Stems to be Removed by the Owner before StsK: of Remediation: 

! he :c-riOVc.!: giofcce, ois>'Ofct.l. j-no/oi -et./i.-t o.' thc.^;b iifcirifc' i?- lrig; Ov.-h£i i lesf.ciiSi^.iiity, 

I ttem 

^ ^ 

) Kem: 7^ 

ftem: 

Kem: 

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

Item: ^ ^ / _ , , 

^ ^our U NQ/w 'E>OtiZ. <X\/^/f 1 iUci-cs HSU-Si QkL 

ItecM: 

'fp "02^ 

Item: 

Page 1 o f ^ 
C vJ i4 S T M L r»<v<KONM(MtA I 

ltgms_tc_B6 Removed Ey Contractor I g.nd,Repjaced 

ISem: 

Kem: 

-^

r, Item: 

i 

i Item: 

litem 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 

trunlc diameter 

Number of trees <= 2 inch 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Atiach n skeicli ol ihc 

>fi',il-lci l;;\c.Li! 

Number of and size of 

each garden/ flower bed 

area. 

Alliich <i skclcli (ll rfl;ili\f 

iixor- ii!ici Ior:lll0ll^. 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

js'-i ' •.(• '!•;: : .•: .JIKH ' 

' C'li;' . ."•• •,'] ''; . |-,, r:ir " -

Easement Area, to be 

excavated 

-^—— _ 

Landscape Inventory 

Quantity' Unit Condition/Type/Species 

Quadrants 

-p^,^ ^ 

^ Each 

1 ^ Each 

Each ^ \ ^ 

n^ Each 

Square Feet 

S 

•sft^ Each F^-w( ^ --3 (^s^^^v^ 

^ Page 2 of 
c f f^ s 1 r L 

Additional Commente / InstrucQons: 

! 

^ ^ ^^y- ? N^T^C^ a 

l ^ BKk?)^ oF t^t > KUL6K J FA^mCK. 

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. 

;^he < 

I agree Q I do not agree 

i , ipl'^Cfl, Owners Signature Date Contractor's Signature Date 

Page 3 of {_ 
BVID # (cS^^t 

XRF PROPERTY SAMPLE SHEET 

Date -^mm- Address •ZiaU F<yHf pp(tf> <i.\ 

Project Omaha.lead FP 2nd year option Sample time am/pm 

XRFID # ^?P?>q sample length 30 sec 

Shot# Reading Sample area Shot # Reading Sample area 

?pn9\ vyt.<Ai\\^i3 < 0 ^ Mai. -ivxoi gT;>,a>^vo.i^ ^^^ M Pt 

.^?y 5 ^M.iV>:i^\\.\1 Depth a^<^^ Aft.QTi:ll.^<^ Depth 

'}P)%\ IM-^S^WiSZ. I33qu 1^5.13^^ lUHwl (p 

Average ^'b-CfP ^ WA S Average MPv.T ^ J . \<.Q 1 

Shot# Reading Sample area Shot# Reading Sample area 

"W^ sx 

Depth Depth ^ n.g>u>t^7?>\g 339NV0 -IS.ft-jiiUTA 

Average P>\nn^- t M.QI A Average 

Shot# Reading Sample area Shot# Reading Sample area 

n:^A<^^ii.(3i 23_a^ , ^ 33?V^ \\^.^<^^\^.^'7 r.P^' 

33 V^ ffflx.2t^J-lA.ft^ Depth Depth 

35qi F;p>..^^fcv^/\m 

Average -^\ o .Tkc ^ \\.(\9- ^ Avel^ge 

RETEST AREAS 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

lab sample # Lab iresult Sample area XRF Avg. 

Signature. C^hBj(^6 

Print ? \ i o n hPi- h CpOPfP ^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3382 

Mode SOIL 

Time 2009-08-18 08:49 

Duration 121.56 

Sequence Final 

Flags 

AVERAGE 

ADDRESS 

QUAD/ZONE DZ 

INSPECTOR nicolas 

DEPTH 10 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb 

Supervised By: ^MJ^ata h 
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 173.541 

Supervised By: 

Certificate of Verification 

3378 

SOIL 

2009-08-18 08:47 

30.52 

Final 

63541 

2744 fontenelle blvd 

DZ 

nicolas 

10 

CLEARANCE 

± Error 

± 16.233 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3379 

Mode SOIL 

Time 2009-08-18 08:48 

Duration 30.08 

Sequence Final 

Flags 

BVID # 63541 

ADDRESS 2744 fontenelle blvd 

QUAD/ZONE DZ 

INSPECTOR nicolas 

DEPTH 10 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 57.825 ± 10.279 

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 74.001 

Supervised By: 

Certificate of Verification 

3380 

SOIL 

2009-08-18 08:49 

30.52 

Final 

63541 

2744 fontenelle blvd 

DZ 

nicolas 

10 

CLEARANCE 

± Error 

± 11.166 
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 74.845 

Supervised By: 

Certificate of Verification 

3381 

SOIL 

2009-08-18 08:49 

30.44 

Final 

63541 

2744 fontenelle blvd 

DZ 

nicolas 

10 

CLEARANCE 

± Error 

± 11.316 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3387 

Mode SOIL 

Time 2009-08-18 08:53 

Duration 121.64 

Sequence Final 

Flags 

AVERAGE 

ADDRESS em.(ssmm^^^ 2744 fontenelle Divd 

QUAD/ZONE PZ 

INSPECTOR nicolas 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

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 117.378 

Supervised By: 

Certificate of Verification 

3383 

SOIL 

2009-08-18 08:51 

30.49 

Final 

63541 

2744 fontenelle blvd 

PZ 

nicolas 

6 

CLEARANCE 

± Error 

± 13.738 
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 56.331 

Supervised By: 

Certificate of Verification 

3384 

SOIL 

2009-08-18 08:51 

30.48 

Final 

63541 

2744 fontenelle blvd 

PZ 

nicolas 

6 

CLEARANCE 

± Error 

± 10.274 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3385 

Mode SOIL 

Time 2009-08-18 08:52 

Duration 30.16 

Sequence Final 

Flags 

BVID # 63541 

ADDRESS 2744 fontenelle blvd 

QUAD/ZONE PZ 

INSPECTOR nicolas 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 97.858 ± 12.860 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3386 

Mode SOIL 

Time 2009-08-18 08:53 

Duration 30.51 

Sequence Final 

Flags 

BVID # 63541 

ADDRESS 2744 fontenelle blvd 

QUAD/ZONE PZ 

INSPECTOR nicolas 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 75.569 ± 11.292 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3392 

Mode SOIL 

Time 2009-08-18 08:56 

Duration 121.48 

Sequence Final 

Flags 

AVERAGE ' mgwms^mm', ADDRESS ,£./HH roriLeneiie oivd 

QUAD/ZONE easement 

INSPECTOR nicolas 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

± 

: ^dfPj M 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3388 

Mode SOIL 

Time 2009-08-18 08:54 

Duration 30.15 

Sequence Final 

Flags 

BVID# 63541 

ADDRESS 2744 fontenelle blvd 

QUAD/ZONE easement 

INSPECTOR nicolas 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 73.990 ± 11.006 

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 114.885 

Supervised By: 

Certificate of Verification 

3389 

SOIL 

2009-08-18 08:55 

30.47 

Final 

63541 

2744 fontenelle blvd 

easement 

nicolas 

1 

CLEARANCE 

± Error 

± 13.268 
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 58.241 

Supervised By: 

Certificate of Verification 

3390 

SOIL 

2009-08-18 08:55 

30.46 

Final 

63541 

2744 fontenelle blvd 

easement 

nicolas 

1 

CLEARANCE 

± Error 

± 10.025 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3391 

Mode SOIL 

Time 2009-08-18 08:56 

Duration 30.40 

Sequence Final 

Flags 

BVID # 63541 

ADDRESS 2744 fontenelle blvd 

QUAD/ZONE easement 

INSPECTOR nicolas 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 58.350 dk 10.035 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3397 

Mode SOIL 

Time 2009-08-18 08:59 

Duration 122.07 

Sequence Final 

Flags 

AVERAGE 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm ± Error 

Pb 1^8.733: ± ij|l5;668'| 

Supervised By: C^Jl/^''JU2 1 ^ 
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 247.851 

Supervised By: 

Certificate of Verification 

3393 

SOIL 

2009-08-18 08:57 

30.59 

Final 

63541 

2744 fontenelle blvd 

F2 

nicolas 

6 

CLEARANCE 

± Error 

± 19.048 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3394 

Mode SOIL 

Time 2009-08-18 08:58 

Duration 30.51 

Sequence Final 

Flags 

BVID # 63541 

ADDRESS 2744 fontenelle blvd 

QUAD/ZONE F2 

INSPECTOR nicolas 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 93.283 ± 12.376 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3395 

Mode SOIL 

Time 2009-08-18 08:58 

Duration 30.49 

Sequence Final 

Flags 

BVID# 63541 

ADDRESS 2744 fontenelle blvd 

QUAD/ZONE F2 

INSPECTOR nicolas 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 88.072 ± 12.389 

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 165.726 

Supervised By: 

Certificate of Verification 

3396 

SOIL 

2009-08-18 08:59 

30.48 

Final 

63541 

2744 fontenelle blvd 

F2 

nicolas 

6 

CLEARANCE 

± Error 

± 16.461 
JM # • 

i Jfk^ \, Omahmahaa Lea I . d Site—Fixe .. d Price EP-R7-07-0 . _. __ 5

Coastal Environmental Group Inc. V 

V"*^ ^ www.coastalhazmat.com ^ ^ 

%PBOi«^ COASTAL IIIVIIOIINEMTAl 

SIO U r, IN C 

EXECUTIVE SUMMARY: 

BVID #63541-(2744 FONTENELLE BLVD) 

No Issues or Concerns [^ Issues/Concerns 

Detail Explanation: 

-COASTAL TO BRING 2 BAGS OF RED MULCH. (COMPLETED 9/1/09) 
•

4»EPA 

EPA Property Close Out Form 

Property#: ^35U l . , P,^«,_.^pdHJagiea£Jl£fo»«» 

Date/Tine: ^^ Owacr*s Name: A^JiUj^y.'QVTi W •< • 

Quads Eicavattd: F L P? : P ^ Contracto -CJ r C.rouf^X't^*?AaJi FrU/l'nP 

Yes 'tA Excavation General 

1. If necessaiy, were the correct quadrant(s) excavated and restored? 

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

Grading Sod and VegctetloB Yes N

I. Does the gnuling around the perimeter ofthe house in excavated areas generally slope away 

from the house? 

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

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

day time period) ______ ^ 

4. Are sodded areas generally finn and evenly graded? 

5. Arc 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 propert>'? 

7. Was damage to landscaping or plant materials avoided? 

Gates. Feacea aad Retaining Walls 

Yes !X» 

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

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

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

/ 

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

Foupdatton, Sidtag and Goiters 

Yes No 

I. Was damage to the siding or trim avoided? ^ 

2. Was damage to the foundation avoided? 

A 

3. Was damage to windows avoided? 1 / 

4. Was damage to windows or door screens avoided? 

5. Was damage to downspouts or downspoul extensions avoided? ^

' 

Sidewalks «nd Driveways (Concrete) 

Vcs/No 

1. Was damage to driveway surfaces avoided? Tf 

2. Was damage to walkway surfaces avoided? V' 
Owners comments: # 

Inspection notes: 

Removal and restoration activates complete including the 30-day sod warranry 

EPA Representative J_)G ^ ijjcJkJ ^ Date: X / ^ 
9 

Property Completion Agreement 

•fills aBrecmcnl documents the complclion of remedial activili&s performed on my properly. My signalure 

will designale that I am satisJied wilh llie restoralion of my properly, and llial no items are in questions, 

now, or al any time in tiie fulure, excepl those item.s li.sled below, ifany. 

Pi-opcrlyJID: J^5^^ ^ _ _ 

Property Address:" "2,7^^ " /jgj^ tC^^U<^S^J>_ _ 

Owner: ^^\Z^_\,(^oi/^C ^ 

I'honc: ^-77 . 3^7 ^ 

Restoration Items in Question: 

Item: 

^ 

Item: 

Item: 

Additional Comments: 1 A 1 , I / 

1 

\ 

-Ssr;.saurci r - restomtion i.s completed, except as noted 

L l I do noe.ji(;i-pc-»-cs(orHti«n is completed 

Cnntriicfor's .Siijnaturo H)atc