### CONTRACT 

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


### ECC Certification for Property Closeout

OLSID 29471 

### Property Address 2806 N 26 St 

### Field Work Started 

### 9130/2007 Field Work Completed 10/11/2007 

### Summary: 

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

## • F1 excavation depth was 4 inches below ground surfaces. 

# • B 1 excavation depth was 12 inches below ground surfaces. 

## • B2 excavation depth was 4 inches below ground surfaces. 

## • Verification samples confirmed that cleanup standards were met. 

## • The site was backfilled with material which meets the contract specifications. 

# • The backfill was compacted to acceptable standards. 

## • Site restoration were conducted in compliance with the specifications and work plans.



### Comments: None

D2 IV,-' 1I0 

## 1 ECCOCM Title Date ature Jeff Hubbard USACE Con Rep 

## - 07 

## 51 

# J.J]?JlLj Name Title

### Sign~>.: Exterior Paint 

### Omaha Lead Site Owner Name: 

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## WYll n 

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### Site**~!<etch** Address:

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### f.6ro\NV1 OLS

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## 7.5 XRF Code 

### -_---:.-!-=--- Quadrant Lead Concentration Date FI II 

## qq ppm 

### IO/U / 07 F2 

### Ihq ppm BI 

### \2 11 ZSO ppm B2 if // 

## /oer ppm LogBook 

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# AiitA CONTRACT 

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

# 1m

us Army Corps

of Engineers .ECC. 

# ..

Analytical Results Summary OLS #29471 2806 N 26 th 

### Sf

Depth Date Collected XRF Results (ppm) (avg.) 10/11/2007 

## I 99 

# I 12 I 10/11/2007 

## I 250 

### I 

## I 4 I 10/11/2007 

## I 109 

### I 0 10/11/2007 1 121 

### I 

## I Sample Quadrant

Type

DE F1 

# I DE 

# I 61 

# I DE 

### II 62 

# I DE 

# I EA-E 

## I II 

# I I

SAMPLE 10- SAi\1PLE ID is a particular residential property ID from which the sample is collected. The sample type identifier (WIth sequential sample number for that location) as follows; PX = Pre-Excavation XRF sample DE = During and Post Excavation Quadrant describes the sampling location (with sequential sample number for that location) as follows; FI or F2 = Front Yard One or Front Yard Two Bl or B2 = Back Yard One or Back Yard Two DZ= Dnp Zone GA Garden PA Play Area EA Easement Depth descnbes the depth from which the sample was collected. ppm = parts per million

## page 1 

## of_

Omaha lead Site Omaha.NE Residential Yard Soils Environmental Restoration Services U.S. Environmental Protection Agency Region VII 

# • PROPERTY ACCESS (to be completed by property owner)**~:.** :. ''':' -: ::. S :.1

. c;' • -. ':.. ':...**,~. ~':"'.** **~IC-'** ,I

.. ·... . : C**~.** ....**~::.** U.S. Environmental Protection Agency (EPA) has contracted the U.S. Army Corps of Engineers (USACE). Omaha District to conduct environmental restoration services for the Omaha lead Site. USACE Omaha is working with Environmental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration

ervices. Your cooperation is requested in giving EPA/USACE/ECC permisSion to access your property during the emovallrestoration phase. For further information please contact Don Bahnke, EPA Project Manager at (913) 551­ 003 or the Office of External Programs. at 1·800-223-0425. Property Access Granted By

Property Owner Signature)


## ., . NOTE G f 

### , 

# . DOES NOT 

# . ,. rt "II b eel" 

### t d tth' f PROPERTY INFORMATION (to be complered by reSident iJnd or propf>r1y owner· Please Print) Resident Name: 

## V!1cG NT 

## Lt2r Downer 

# o renter Residence Address:

__**.CI:;~8j~'tJ~6_~N!..--..l~_(P~sr~** 

## __ (CITY) (STATE) (ZIP) Property Owned**By:_--L.rn&.+Lt4uR:lo.....bL<.Ld~-'lt~')'--yJ-LJI.N'--"J1)..IL......** 

### _ Owners mailing address: 

# tzJ. Jf¥ ((€lib .$r Owner's telephone number • Home:

__**--""S""--t)~J_---.:..,J.{~fR.~'J~t,'---** Age of Home?

______ years How long have you lived here?

_____ years Has the exteior been painted or**cove~ed** with siding since 1978? DYes 

# o No Has the interior been painted Of' covered since 1978? DYes 

# o No lTotal number of occupants:
_ List Ages:**--------------------~I** list ages of occupants under 6 years old who play in the yard for 5 or more hours per week:

_ Comments: [AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS Irhe activities to be implemented by EPA under this agreement are pursuant to section 104 of CERCLA, 42 U.S.C. 9604. EPA's right 

# 0' access to he property for in section 104(e) of CERCLA, 42 U.S.C. 9604 (e). which provides entry for. "determining !he need 'or response, or choosing or aking any response action under this IiUe, or otherwise enforcing the provisions of this title." Access Attempts: First**~--** Second: : Third: : _pg._of_ 

# List of Existing Conditions Property Add ress:

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# _ DVO 10 

## # 

# d9'17/ Date:

_ Owner:

. aVID# 

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### Ref: 

### Photo Description # 

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### Owner Signature ECC 

### Print & 

### Sign Print & 

### Sign

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

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

# I DVID 

## qlf / 

## .1 )(Ot-J N 

## 'rlt sr Q...NO Property Owner 

### Is the Owner the Resident? DYes

. fl)l4,() L W 

### if ,uA.1 

### Compliance Statement: 

### U.S. Environmental Protection Agency (EPA) has contracted the U.S. Army Corps of Engineers (USACE), Omaha District to conduct environmental restoration services for the Omaha Lead Site. USACE Omaha is.working with Environmental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration services. Your cooperation in giving EP NUSACElECC permission to access your property during the removal/restoration phase is sincerely appreciated. This document certifies that all work performed at this property was completed in accordance with the contract specifications and EPA requirements. If you have questions or need additional information please contact Don Bahnke, EPA Project Manager, at (913) 551-7003 or the Office of Ex tema I 

### Programs at 1-800-223-0425. Additional Comments by USACE and/or ECC:

CONTRACTOR CERTIFICATION 

### ECC Project Manager Name Title Date Signature

. - 

### PROPERTY OWNER SECTION This agreement documents the completion of remedial/restoration efforts at the property to my satisfaction. Tagree that restoration is completed at my property, except as noted Comments (if 

### applicable):



### . 

# [x% /lA/At)

# ~?f!1crn A\ . /



### Properly Owner's Signature 

# U Date 

## / d--oo-O'J

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

__**...!:£-=...;c.~C** 

### _ Property Identifier Number:
_ Property OVID Number:**~_~"':""L......I.~** __**~_** 

### Property Address:**J=;:;.:.~~O~~~** ... 

### N:....-.-J

__



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_ 

### Property Owner's Name:**~_.::..m.L..L.lt3.L.' illl.e-'lJ...~8"",-.w;\N~V** **IJJ~U_·** _ (above infonnation to be filled out by remediation contractor prior to delivery of fonn to Property Owner) 

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

### This fonn is provided to you as a means of trying to capture your level of satisfaction with the work of the above-identified Remediation Contractor, as applicable to the soil cleanup action at your property. The U.S. Environmental Protection Agency (EPA) and the U.S. Army 

### Corps of Engineers (USACE) are very interested in your opinion regarding the work performed by our 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 work by selecting a nwnerical rating (ranging from 1 to 10) using the following rating scale, then please sign & 

### date the form and return it to USACE in the attached self-addressed & 

### stamped envelope. (Additional comments may also be 

### provided in the space provided, at the option of the property owner.) 9-10 "excellent" 7-8 "very good" 5-6 "acceptable" 3-4 "poor" 1-2 "very poor" Property Owner's Satisfaction Rating regarding Contractor's Work 

### 10 5 9 4 8 3 7 2 6 1 

### Additional Comments from Property Owner (optional; continue on back of page ifneeded>

Property Owner's Signature: Date: 

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